After treatment with semaglutide, newly diagnosed Type 1 diabetes patients needed little or no insulin

Treating newly diagnosed Type 1 diabetes patients with semaglutide (trade names Ozempic, Wegovy and Rybelsus) may drastically reduce or even eliminate their need for injected insulin. Those are the remarkable findings of a small University at Buffalo study reported in the New England Journal of Medicine. “Our findings from this admittedly small study are, nevertheless, so promising for newly diagnosed Type 1 diabetes patients that we are now absolutely focused on pursuing a larger study for a longer period of time,” says Paresh Dandona, MD, PhD, senior author on the paper.

A total of 10 patients at UB’s Clinical Research Center in the Division of Endocrinology were studied from 2020 to 2022, all of whom had been diagnosed in the past three to six months with Type 1 diabetes. The mean HbA1c level (an individual’s average blood sugar level over 90 days) at diagnosis was 11.7, far above the American Diabetes Association’s HbA1c recommendation of 7 or below. The patients were treated first with a low dose of semaglutide while also taking meal-time (bolus) insulin and basal (background) insulin. As the study continued, semaglutide dosing was increased while mealtime insulin was reduced in order to avoid hypoglycemia.

“Within three months, we were able to eliminate all of the mealtime insulin doses for all of the patients,” says Dandona, “and within six months we were able to eliminate basal insulin in 7 of the 10 patients. This was maintained until the end of the 12-month follow-up period.” During that time, the patients’ mean HbA1c fell to 5.9 at six months and 5.7 at 12 months.

The most common side effects for patients were nausea and vomiting as well as appetite suppression, which led a number of patients to experience weight loss, an outcome that Dandona says is generally an advantage since 50% of patients with Type 1 diabetes in the U.S. are overweight or obese.

Dandona said, “We were definitely surprised by our findings and also quite excited. If these findings are borne out in larger studies over extended follow-up periods, it could possibly be the most dramatic change in treating Type 1 diabetes since the discovery of insulin in 1921.”

Sources:

ScienceDaily, September 6, 2023; see source article Dandona et al, New England Journal of Medicine, 2023; 389 (10): 958 DOI: 10.1056/NEJMc2302677