Ozempic: Sugar Coated Success or the Best of Its Kind?

By Candis Morello and Parisa Karimian

In December 2017, Ozempic (semaglutide) received U.S. Food and Drug Administration (FDA) approval for the treatment of adults with type 2 diabetes (T2D).

Combined with eating healthy meals and regular activity, Ozempic may be used alone or with other diabetes medications. Ozempic is the 4th once-weekly glucagon like peptide-1 receptor agonist (GLP-1 RA) medication to enter the market after Bydureon (exenatide extended release), Trulicity (dulaglutide), and Tanzeum (albiglutide). Ozempic is expected to be launched in the U.S. by the spring, shortly before Tanzeum’s discontinuation from the market due to issues with sales. Ozempic sets itself apart from other once-weekly GLP-1 RAs by demonstrating the quickest and greatest effect in reducing blood glucose and body weight in studies. In addition, a pill version of Ozempic is now under evaluation in clinical trials.

How Does Ozempic Work?

Similar to the other once-weekly products, Ozempic is a GLP-1 RA. Even though it is synthetic, it acts similarly to the hormone GLP-1 naturally produced by the body that is deficient in people with T2D. It promotes the pancreas to release insulin (only when glucose values are elevated), makes people feel fuller faster so they tend to eat less, and reduces the amount of glucose made by the liver. Overall glucose concentrations are better controlled throughout the day and after meals, and most people lose some weight.

How is Ozempic Used?

Ozempic comes in easy-to-use prefilled disposable injector pens of either 0.5mg or 1 mg strengths. Since Ozempic has a long half-life (about seven days), it only needs to be given once per week. Select one day of the week (like Sunday, as an example) and make that your Ozempic day. To help you remember, you can mark your calendar or set a reminder alarm in your phone.

If you miss your day and remember within five days, administer it as soon as possible and set that day of the week as your NEW Ozempic day. If it is less than two days away from your next dose, wait the two days to administer.

Choose an administration site on your stomach (at least two inches away from your belly button), thigh, or upper arm. After uncapping the pen place the pen tip against your skin. Now, you are ready to press the injection button. Keep the button pressed down for 5-10 seconds to ensure complete dose delivery. Each week use a different injection site or rotate within that side. Each pen only contains four doses. Once empty, dispose the pen in a sharps container. New pens should be stored in a refrigerator, away from light in the original box.

 What Can You Expect?

Ozempic improves both fasting and post-prandial (after meal) blood glucose concentrations; however, based on its long-acting formulation, it has a stronger effect on fasting plasma glucose. You can expect your A1c to reduce by about 1.2- 1.8%, depending on the weekly dosage used. Ozempic, like other GLP-1 RAs, is associated with low risk of low blood glucose (hypoglycemia). One benefit of Ozempic is weight loss up to 13 lbs, which is considerably greater than reports from other GLP-1 RAs on the market.

Additionally, data from the clinical studies suggest that Ozempic reduces risk of cardiovascular problems including stroke and heart attack. Longer-term trials will confirm these benefits.

Like other GLP-1 RAs, a common side-effect of Ozempic is the slowing down of stomach emptying. In addition, mild to moderate stomach upset and nausea may occur. These symptoms usually go away within a few weeks from starting Ozempic. To reduce the indigestion symptoms, eat smaller food portions throughout the day.

Is Ozempic Right for You?

Before starting Ozempic, you and your provider will want to discuss your medical and family history. Specifically discuss if you have problems with your pancreas or kidneys, have a history of diabetic retinopathy, are pregnant or planning to become pregnant, have any history of severe gastrointestinal (GI) disease, thyroid cancer, or family history of thyroid cancer. Getting an annual dilated eye exam is also recommended. Also, be sure to inform your provider of all prescriptions, over-the-counter, and herbal medications that you are taking, to avoid any interactions.

The Bottom Line:

Compared with other GLP-1 RAs, Ozempic is a strong A1c reducer with the added benefits of moderate weight loss and possible cardiovascular protection. The results of future studies will provide clinicians with more insightful information of which once-weekly GLP-1 RA is best for each individual patient. Consult with your provider to see if adding Ozempic is the next beneficial step to reach your personal glucose goals.


About the Authors:

 Parisa Karimian, 4th Year Student Pharmacist at UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences.

Candis M. Morello, Pharm D, CDE, FCSHP, FASHP, Associate Dean for Student Affairs at UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, Clinical Pharmacist Specialist at VASDHS.


TCOYD Online Workshop: Basal Insulin and Type 2 Diabetes

In this three-part online educational series, Dr. Steve Edelman, MD and Dr. Jeremy Pettus, MD cover Basal insulin, and how it can help people with type 2 diabetes.

Remember, don’t make any change to your diabetes treatment plan without the guidance of your healthcare provider.

PART I: What Is Basal Insulin and How Can It Help Me Take Control Of My Diabetes?

This activity is for people with type 2 diabetes, your caregivers, and others who are interested in learning about basal insulin.

In part I you will learn about:

  • How basal insulin works
  • The benefits you can expect from basal insulin therapy
  • Common fears people have about basal insulin therapy
  • The different kinds of basal insulin
  • The primary goal of treatment with basal insulin








PART II: How Do I Know If I Am on the Right Dose of Basal Insulin?

Once you and your healthcare provider have decided to begin basal insulin therapy, the next step is to determine the right dose for you. Each person’s basal insulin requirement is different, and it is affected by several factors.

In part II you will learn:

  • How to reach your goal number with basal insulin
  • How to titrate, or adjust, your dose of basal insulin
  • Self-titration methods you could use with your healthcare provider’s guidance








PART III: Your Diabetes Treatment May Change Over Time

Type 2 diabetes is a chronic condition that affects the way your body processes blood sugar (glucose). When you have type 2 diabetes, your body either doesn’t produce enough insulin, or it doesn’t use insulin properly.

In part III you will learn the basics of type 2 diabetes:

  • The causes
  • It is a chronic condition that progresses over time
  • As your diabetes progresses, your treatment may change


Raise Awareness for Diabetes with Your Warrior Call!

Join forces with TCOYD during Diabetes Awareness Month and show the WORLD what it means to be a diabetes WARRIOR!

Post your best warrior call to Facebook or Instagram! Your warrior call can be anything you want it to be – a photo, a video, a look, a shout or a song. Tag @Dexcom, use the hashtag #WarriorUp and help us raise diabetes awareness during the month of November!

For every post and share of your photo, Dexcom will donate $2 to be split between five amazing organizations doing amazing things for people with diabetes.

Check out the campaign video from Dexcom!


So get those cameras out and let’s see and hear those warrior calls!