People with type 1 diabetes generally have to inject insulin daily (Picture: Getty)
Semaglutide, the ‘miracle’ weight loss drug developed to combat type 2 diabetes, could remove the need for insulin injections in patients with type 1 diabetes – transforming the lives of millions.
If repeated, the results of a small study ‘could possibly be the most dramatic change in treating Type 1 diabetes since the discovery of insulin in 1921’, according to one of the study’s authors.
Type 1 diabetes occurs when the body’s immune system attacks and kills the cells in the pancreas that produce insulin, which is required to maintain a healthy blood sugar level. Most patients are required to inject insulin several times a day.
In Type 2 diabetes the pancreas cannot make enough insulin, rather than none at all. Recent treatment breakthroughs have included the drug semaglutide, sold as Ozempic, Wegovy and Rybelsus, which enables better management of blood sugar levels – and also aids weight loss.
However, a New York-based professor of medicine and his team investigated whether the drug could also benefit those with type 1 diabetes.
Over two years, the team followed 10 patients who had been diagnosed with type 1 diabetes within the previous three to six months. Their average blood sugar level, or HbA1c, 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 background (basal) insulin. As the study continued, the semaglutide dose was increased while mealtime insulin was reduced in order to avoid hypoglycaemia.
Semaglutide is marketed under different brand names, and has been widely adopted as a weight loss drug (Picture: EPA)
‘Within three months, we were able to eliminate all of the mealtime insulin doses for all of the patients,’ said team leader Dr Paresh Dandona, State University of New York distinguished professor. ‘Within six months we were able to eliminate basal insulin in seven of the 10 patients. This was maintained until the end of the 12-month follow-up period.’
In addition, the patients’ average blood sugar level fell to 5.9 after six months, and 5.7 after a year.
Some patients suffered side effects, including nausea and vomiting as well as appetite suppression. This led to a number of patients also experiencing weight loss – an outcome that Dandona says is generally an advantage given 50% of patients with Type 1 diabetes in the US are overweight or obese.
‘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,’ said Dr Dandona.
‘As we proceeded with the study, we found that even the dose of basal insulin could be reduced or eliminated altogether in a majority of these patients. 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.’
The study is published in the New England Journal of Medicine.
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The treatment could change millions of lives.