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.

social media concept (like, tweet, follow, share, comment). Paper signpost on a wooden desk

Not Sure You’re Ready to Dive into an Online Diabetes Community?
We Can Help!

Diabetes can be an overwhelming and often very lonely condition to tackle. It’s something we can’t just turn off or deal with later; it’s there 24/7 and it can be hard for the people around us to truly understand what it’s like.

But please know that you are not alone! There’s a global diabetes community ready to support you, and you can participate as much or as little as you like. Even if you’re not ready to (or interested in) meeting other people with diabetes in person, there are several ways in which you can communicate or just listen in and learn from people in the same situation as you, by tapping into the Diabetes Online Community (DOC).

The beauty of the DOC is that you can access it from anywhere, as long as you have internet connection. There are probably other platforms as well, but the ones I have found to be the most powerful are Facebook, Instagram and Twitter.

DOC on Facebook

There are over 100 support groups for people living with diabetes just on Facebook. There are groups only for women, for parents, for athletes, for foodies, Dexcom lovers, you name it.

What’s important when choosing your Facebook group(s) is that you like the tone and content of the group. Some groups are very focused on the emotional parts of diabetes, some are very “how-to”, and some have strict rules for what you can post. You may want to join a few groups and see if they fit what you need. Remember, you can always leave the group if it’s not right for you.

Simply do a search on Facebook for “Diabetes” and choose “groups”. A few of the larger groups are Type 1 Diabetes, Type 2 diabetes support group global network and Diabetes Strong Community (Full disclosure, the last group is mine). While many groups are diabetes type specific (type 1, type 2, etc.), the Diabetes Strong Community is a global peer support community welcoming people living with all types of diabetes.

I see posts almost daily from people saying that the Facebook diabetes community has changed their lives and that they now for the first time have a support group of people who understand what they are going through. It’s such a powerful thing and I really encourage you to at least join for a while to see if you like it.

Note: Many Facebook groups now have a questionnaire when you try to join asking why you want to join the group. This is not to collect your information, but to make sure that the people who join the groups fit the profile, and to reduce the risk of letting in “internet trolls” and people selling fake diabetes cures.

DOC on Instagram

Instagram is a fun platform where you can get a glimpse of how other people tackle their diabetes on a daily basis. You don’t interact with a big group like you do on Facebook, but it’s an opportunity to connect with individuals in an informal way and get to know them a little.

The good thing about Instagram is that it’s very easy to find the DOC. You simply search for the hashtag #diabetes and go from there. Once you start “liking” diabetes-related posts, Instagram will automatically start recommending similar profiles.

Since it’s a more informal platform, this is most likely not the place where you get the deep connections that you can get on other social media platforms, but it can be fun and informative.

Note: Because people only show a very small part of their lives on Instagram (often the best parts), Instagram profiles can sometimes show a slightly one-sided view of what living with diabetes is like.

DOC on Twitter

The DOC is very active on twitter and the hashtag #DOC is frequently used. Several twitter chats are hosted weekly and you can follow along and read people’s answers or dive in and participate yourself. Twitter is also a very active platform for diabetes advocacy if you’re interested in getting into that.

One of the strong Twitter chats is the #DSMA (Diabetes Community Advocacy Foundation) chat every Wednesday at 9 p.m. U.S. Eastern Standard Time. There’s usually a weekly subject and the chat is guided by a moderator who lists a series of questions that people then chime in with answers to.

It’s not just for people living with diabetes but also caregivers and family members.

Note: If you get stressed out by having to participate in real time chats (I know I do), you can always go back and add your answers at a later time. Just search #DSMA, and the questions will show up.

Venturing Beyond the DOC

If you’re ready to connect with other people living with diabetes in “the real world”, there are plenty of opportunities to connect with others both in larger settings and more intimate ones.

Since you’re reading this post on TCOYD, you might already know about the many TCOYD conferences held across the U.S. But if you don’t, these events present a great opportunity to meet other people living with diabetes and learn more about different diabetes topics presented by top-notch diabetes experts.

If you live in the US and you prefer smaller gatherings, try searching for local groups on Meet Up, check out the local Diabetes Sister chapter (only applicable for women) or reach out to your local ADA or JDRF.

You can also use the online community to find local events. As an example, we have a local group of people with diabetes here in Los Angeles who meet up regularly to go to Disneyland together. They coordinate their meetups on Facebook, Instagram and Twitter.

I hope this post has intrigued you and made you curious to explore the DOC and meet others living with diabetes and facing similar daily challenges. If you’re still hesitant, please know that:

You are not alone

You do not have to deal with this alone

There is an ocean of people living with diabetes who will gladly support you.

Come join us!

To read more from Christel and the DiabetesStrong community, visit DiabetesStrong.com.