From the Guidelines
Yes, patients with Type 1 Diabetes Mellitus (DM) can take Ozempic (semaglutide) and insulin together, but this combination should only be used under close medical supervision. According to the most recent evidence from 2023, Ozempic is primarily approved for Type 2 diabetes, but some endocrinologists prescribe it off-label for Type 1 diabetes as an adjunct to insulin therapy 1. When used together, Ozempic may help reduce insulin requirements, improve glucose control, and potentially assist with weight management. However, this combination requires careful monitoring as it may increase the risk of hypoglycemia (low blood sugar) 1.
Key Considerations
- Patients should be vigilant about checking blood glucose levels frequently and may need their insulin doses adjusted downward when starting Ozempic.
- The typical starting dose of Ozempic is 0.25 mg once weekly for four weeks, then increasing to 0.5 mg weekly if needed.
- Patients should maintain their prescribed insulin regimen but be prepared to adjust doses based on their doctor's guidance.
- This combination works because while insulin allows glucose to enter cells, Ozempic slows gastric emptying, reduces glucagon secretion, and may improve insulin sensitivity, providing complementary mechanisms for blood glucose control.
Monitoring and Adjustments
- Close medical supervision is necessary to monitor for potential adverse effects, such as hypoglycemia and hyperglycemia with ketosis.
- Patients should be educated on the signs and symptoms of ketoacidosis and seek medical attention immediately if they occur 1.
- Regular monitoring of blood glucose levels, weight, and lipid profiles is essential to adjust the treatment plan as needed.
Conclusion is not allowed, so the answer ends here.
From the FDA Drug Label
• When using OZEMPIC with insulin, instruct patients to administer as separate injections and to never mix the products. It is acceptable to inject OZEMPIC and insulin in the same body region, but the injections should not be adjacent to each other.
Yes, patients with Type 1 Diabetes Mellitus (DM) can take Ozempic (semaglutide) and insulin together, but they must be administered as separate injections and not mixed. It is also acceptable to inject them in the same body region, as long as the injections are not adjacent to each other 2.
From the Research
Patient Considerations for Ozempic (Semaglutide) and Insulin Use
- Patients with Type 1 Diabetes Mellitus (T1D) may be able to take Ozempic (semaglutide) and insulin together, as evidenced by a study 3 that evaluated the real-world use of semaglutide in patients with T1D.
- The study found that the use of semaglutide in patients with T1D was effective in lowering body weight and BMI, and improving glycemic metrics 3.
- However, it is essential to note that the study was a retrospective chart review, and further prospective, large-randomized clinical trials are recommended to confirm these findings 3.
Efficacy and Safety of Semaglutide
- Semaglutide has been shown to be effective in reducing glycated hemoglobin (HbA1c) and body weight in patients with Type 2 Diabetes (T2D) 4, 5.
- The addition of semaglutide to basal insulin has been found to significantly reduce HbA1c and body weight in patients with uncontrolled T2D 5.
- Semaglutide has also been found to have a safety profile consistent with subcutaneous GLP-1RAs, with gastrointestinal side effects being the most common 4, 5.
Clinical Guidance for Semaglutide Use
- Oral semaglutide may be considered for patients with T2D who have inadequate glycemic control, require weight loss, or are at risk of hypoglycemia 6.
- However, semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma, and in those with multiple endocrine neoplasia syndrome type 2 6.
- Gradual dose escalation is recommended when initiating oral semaglutide to minimize the risk of gastrointestinal adverse events 6.