Ozempic (Semaglutide) is a new treatment for type 2 diabetes

Ozempic (semaglutide) pen as a treatment for type 2 diabetes


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What is Ozempic (Semaglutide)?

Ozempic is the brand name for a molecule used in the treatment of type 2 diabetes. The generic name is Semaglutide. It is a relatively new product and is a type of injectable therapy, but it is not insulin. It comes in the form of 2 different disposable single use pens in either 0.25mg increments or 1mg increments depending on whether you are starting which, making it relatively safe and easy to administer.

What is the dose of Ozempic (Semaglutide)?

Ozempic starting dose

The starting dose of Ozempic is 0.25mg given a subcutanous injection once per week for 4 weeks.

After this time, and if the person is able to tolerate the medication, the dose should be increased to 0.5mg weekly for at least 3 months when the effect should be assessed.

Ozempic maintanence dose

This is either 0.5mg or 1mg depending on the response to treatment.
The long term mainatance dose depends on whether the blood glucose levels are acceptable. Some people will be able to continue on 0.5mg weekly injections. For people who do not respond enough a futher dose increase to 1mg is suggested.

How do you administer Ozempic (Semaglutide)?

Ozempic is contained in a disposable plastic pen which is based on the Novonordisk flexTouch pen. The process is exactly the same as administering insulin using the flexTouch pen.

For information about the flexTouch pen visit how to use ozempic pen.

Ozempic (Semaglutide) is administered once a week as injection under the skin.

To help remember what day to take your Ozempic (Semaglutide), it is useful to have a reminder in your phone each week. It does not matter what day of the week to administer Ozempic (Semaglutide) so it is best to choose a day that best fits a person's lifestyle. For example, you might choose Sunday as your day to administer Trulicity. You can place a recurring alarm in your phone, so you don't forget. You administer it once every Sunday and that's done. Pretty simple!

Does Ozempic (Semaglutide) cause thyroid cancer?

The simple answer is no, GLP-1s do not cause thyroid cancer in humans.

Early studies demonstrated that when rats were treated with a different GLP-1 therpy in high dose many developed a very rare and lethal thyroid cancer called medullary thyroid carcinoma. Rats have very high levels of GLP-1 receptors in their thyroids. These are not present in human thyroid cell.

The early concern that GLP-1 causes thyriod cancer has lead to extensive investiagtions and studies looking at this issues and to date there has been nothing to suggest a concern despite millions of people being treated with GLP-1 therapies around the world. It is not recommended to use GLP-1 therapies like Trulicity and Victoza (liraglutide) if there is a family history of medullary cell carcinoma of the thyroid or Multiple Endocrine Neoplasia Type 2 (MEN 2).

Who can use Ozempic (Semaglutide)?

Ozempic (Semaglutide) is designed to be used by people with type 2 diabetes. In combination with diet and exercise, Ozempic can help to improve glycaemic control. It is not approved for use in people with type 1 diabetes.

Is Ozempic (Semaglutide) ok to use during pregnancy?

Currently, Ozempic (Semaglutide) is not recommended for pregnant women. Other types of medications are used to treat diabetes in pregnant women.

If you have type 2 diabetes and are looking to start a family or add a new member, it is recommended that prior to conception and throughout pregnancy, your blood glucose levels and HbA1c levels are kept as close as possible to the target goals. These goals may be set by your doctor.

Please see the following articles for more information and diabetes and pregnancy:

Do I have to change my diet if I use Ozempic (Semaglutide)?

If you have type 2 diabetes, making lifestyle changes, for example exercising and eating a healthier diet, is very important.

For ideas on how to reduce the carb content of some of your favourite foods, the article How to reduce carbs in your diet has many great ideas that won’t leave you missing out on flavour.

Does Ozempic (Semaglutide) need to be refrigerated?

Yes. If you have excess Ozempic (Semaglutide) injectable pens at home, they need to be stored in the fridge.

The best place to store your Ozempic (Semaglutide) pens in the fridge, is on the top shelf of the fridge door. The butter compartment is usually the safest place. You shouldn’t store your ozempic pens in the coldest part of your fridge. If the ozempic injectable pen becomes too cold, then the semaglutide will degrade, making it less effective, leading to higher blood glucose levels.

Long term storage should be in a fridge between 2-8℃ (36-47℉). Once the pen is used it can be safely used for 56 days if maintained at a comfortable room temperature of 15-30℃ (59-86℉).

How long does it take for Ozempic (Semaglutide) to start working?

It may take Ozempic (Semaglutide) up to 5 weeks to start lowering your blood glucose levels but the maximum effect will not been seen for 3-6 months.

How long does Ozempic stay in your system

If a person takes Ozempic for a few months and then stops it then it will take about 5 weeks to completely clear the system.

As a general rule with medication if a drug is taken daily then it takes 5 days to get to a steady level and 5 days to clear the system. If a drug is taken weekly then it is 5 weeks to get in and 5 weeks to clear.

Does Ozempic (Semaglutide) cause weight loss?

Yes. Ozempic (Semaglutide) can cause weight loss, although it is not a weight loss drug.

There have been a number of studies examining the effectiveness of Ozempic (Semaglutide) in managing type 2 diabetes. These studies, the Sustain studies, also looked at the associated weight loss in patients using Ozempic. Across most of the studies the average weight loss was about 5kg.

Currently trials are under way looking at using higher doses of weekly Semaglutide as a weight loss drug in those without type 2 diabetes but these are yet to report.

Ozempic vs Trulicity (Dulaglutide)

The Sustain 7 study compared the treatment outcomes of Ozempic with Trulicity. Both of these drugs are once weekly GLP-1 analogues used in the treatment of type 2 diabetes.

Ozempic compared to Trulicity led to:

  • lower blood sugars based on HbA1c by about 0.3% (-1.4% vs -1.1%).
  • Twice as much weight loss with Ozempic (4.6kg-6.5kg depending on dose).
  • More people had HbA1c below the 7% to suggest safer sugar levels.
  • People using Ozempic had more nausea compared to Trulicity.

Ozempic vs Bydureon (Exenatide ER)

The Sustain 3 study compared the treatment outcomes of Ozempic with Bydureon (Exenatide ER). Both of these drugs are once weekly GLP-1 analogues although Bydureon is based in the Exendin molecule rather than human GLP-1) used in the treatment of type 2 diabetes. Exendin is only 55% similar to human GLP-1.

Ozempic compared to Bydureon led to:

  • lower blood sugars based on HbA1c compared of about 0.6% (-1.5%vs 0.9%).
  • Weight loss with Ozempic was 5.6kg vs 1.9kg with Bydureon.
  • More people had HbA1c below the 7% to suggest safer sugar levels.

Ozempic vs Victoza (Liraglutide)

Both Ozempic and Victoza are very similar drugs with both based on human GLP-1. There are some small differences that extends the action of Ozempic and makes it a once weekly treatment for type 2 diabetes as compared to Victoza which is given daily.

So far there have been no direct studies comparing Ozempic and Victoza and it is unlikely that there ever will be as both drugs are made by the same company, Novonordisk. There are some indirect comparison used which suggests Ozempic may be more effective and this is based on Ozempic being more effecive than Trulicity while Trulicity and Victoza were about the same in the AWARD-6 study.

Ozempic (Semaglutide) alternatives

The following drugs are all based on the GLP-1 or Exendine molecule:

Administered weekly

  • Ozempic (Semaglutide)
  • Trulicity (Dulaglutide)
  • Bydureon (Exenatide ER)

Administered daily

  • Victoza (Liraglutide)
  • Byetta (Exenatide)
  • Lyxumia (Lixisenatide)

What are the other effects of Ozempic (Semaglutide)?

Did you know that GLP-1 has many effects in the body?

As we’ve discussed above, GLP-1 is a hormone that is released from our small intestines in response to food. When GLP-1 is released, it binds to specific GLP-1 receptors. These receptors can be found in various areas of the body (GLP-1 Receptor Localization in Monkey and Human Tissue: Novel Distribution Revealed With Extensively Validated Monoclonal Antibody), including in the:

  • pancreas
  • stomach
  • kidney
  • lung
  • heart
  • skin
  • immune cells
  • hypothalamus

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