From the Guidelines
Ozempic (semaglutide) controls diabetes by mimicking a natural hormone called GLP-1 (glucagon-like peptide-1) that helps regulate blood sugar levels, as shown in a study published in 2020 1. When injected once weekly, Ozempic stimulates insulin release from the pancreas when blood sugar is high, slows down the emptying of the stomach after eating, and reduces the amount of glucose released by the liver. It also decreases appetite by acting on the brain's hunger centers, which often leads to weight loss that further improves blood sugar control. Some key points to consider when using Ozempic include:
- Ozempic is typically started at 0.25 mg once weekly for 4 weeks as an initial dose, then increased to 0.5 mg weekly, with possible further increases to 1 mg or 2 mg weekly if needed for better glycemic control, as noted in a study from 2019 1.
- The medication works best when combined with healthy eating habits and regular physical activity.
- Side effects may include nausea, vomiting, diarrhea, and abdominal pain, which often improve over time, as reported in a study from 2018 1.
- Patients should monitor their blood sugar regularly while using Ozempic and stay hydrated, especially if experiencing gastrointestinal side effects. Additionally, GLP-1 receptor agonists like semaglutide have been shown to have beneficial effects on cardiovascular outcomes, with a study from 2020 1 demonstrating a reduced risk of major adverse cardiovascular events. Overall, Ozempic is a valuable treatment option for patients with type 2 diabetes, offering improved glycemic control and potential cardiovascular benefits, as supported by the evidence from studies such as those published in 2019 1 and 2020 1.
From the FDA Drug Label
Semaglutide reduces blood glucose through a mechanism where it stimulates insulin secretion and lowers glucagon secretion, both in a glucose-dependent manner. Thus, when blood glucose is high, insulin secretion is stimulated, and glucagon secretion is inhibited. The mechanism of blood glucose lowering also involves a minor delay in gastric emptying in the early postprandial phase.
Ozempic (semaglutide) controls diabetes by:
- Stimulating insulin secretion in a glucose-dependent manner
- Lowering glucagon secretion in a glucose-dependent manner
- Causing a minor delay in gastric emptying in the early postprandial phase This results in lowered blood glucose levels in patients with type 2 diabetes 2.
From the Research
Mechanism of Action
- Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist that controls diabetes by augmenting hyperglycemia-induced insulin secretion, suppressing glucagon secretion, and decelerating gastric emptying 3.
- It also reduces calorie intake and body weight, which contributes to its glucose-lowering effect 3.
- Semaglutide has a more profound effect on overnight and fasting plasma glucose and HbA1c compared to short-acting GLP-1 receptor agonists 3.
Efficacy and Safety
- Clinical trials have demonstrated the efficacy and safety of semaglutide in patients with type 2 diabetes, with significant improvements in glycemic control and weight loss 4, 5.
- Semaglutide has been shown to have a favorable risk/benefit profile, with mostly mild-to-moderate and transient gastrointestinal disturbances and an increased risk of biliary disease (cholelithiasis) 6.
- The safety profile of semaglutide is similar to that of other GLP-1 receptor agonists, with no unexpected safety issues arising to date 6.
Administration and Indications
- Semaglutide is administered via subcutaneous injection once weekly, and is indicated for the treatment of type 2 diabetes in patients who have not achieved adequate glycemic control with diet and exercise alone or with other glucose-lowering agents 4, 5.
- Oral semaglutide is also available, and has been shown to be effective and well-tolerated in clinical trials, with a safety profile consistent with the GLP-1 receptor agonist drug class 7.
- Semaglutide may also have potential benefits for patients with cardiovascular disease, with studies suggesting that it can prevent cardiovascular events such as acute myocardial infarction or stroke and associated mortality 3.