Dr. Ahmed
Ozempic 2 mg dose has been studied in the SUSTAIN FORTE Trial to assess its efficacy in diabetics who have not achieved optimal glucose and A1C goals.
Based on the findings of the trial, the FDA has approved Ozempic 2 mg dose for treating diabetes [Ref].
Ozempic 2 mg dose is double the previously maximum recommended dose of Ozempic. But it is still lower than the dose used for weight loss.
Semaglutide injections in a dose of 2.4 mg (Wegovy) have been approved for the treatment of weight loss in diabetics as well as non-diabetics.
The approval of Ozempic 2 mg dose weekly for diabetes will help individuals with diabetes achieve better glucose control in addition to losing extra pounds.
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The Efficacy of Ozempic 2 mg for Weight Loss and Diabetes:
Although the SUSTAIN 3 Trial resulted in significant HbA1C reduction. More than 70% (73%) of the diabetic patients achieved the ADA recommended goal of A1C (<7%) with Ozempic 1 mg weekly injection.
However, still, a substantial number of patients required more A1C reduction. This could be achieved by either adding another oral antidiabetic drug, insulin, or increasing the dose of Ozempic to 2 mg weekly.
To study the efficacy of the Ozempic 2 mg dose, the SUSTAIN FORTE Trial was conducted. Participants in the trial had a baseline A1C of 8.9% [Ref].
At week 40, Ozempic 2 mg resulted in a significant A1C reduction compared to Ozempic 1 mg. Similarly, the weight loss effects of Ozempic 2 mg were also greater than Ozempic 1 mg, however, the results were not statistically significant.
The results of the study are tabulated below:
| Efficacy at week 40 | Ozempic 1 mg | Ozempic 2 mg |
| A1C reduction (P <0.01) | ⇓ 1.9% | ⇓ 2.1% |
| Weight loss | ⇓ 12.5 lbs | ⇓ 14.1 lbs |
The trial demonstrated that Ozempic 2 mg dose can treat diabetic patients who do not achieve their target A1C goals.
Although the difference in A1C is minimal (0.2%), it is still significant. In addition, once you are just above your goal A1C of 6.5 or 7%, it’s very difficult to lower the A1C further.
Similarly, a 2 lb weight loss may not be great for some individuals but rewarding for those who are trying hard to lose a single pound.
The better glucose control and weight loss effects came at a price of more gastrointestinal side effects. The percentage of gastrointestinal side effects in both groups is tabulated below:
Safety at Week 40 | Ozempic 1 mg | Ozempic 2 mg |
| Gastrointestinal Side effects | 30.8% | 34% |
Most GI side effects include fullness, bloating, nausea, constipation, abdominal discomfort, and sometimes diarrhea.
Ozempic 2 mg will help patients achieve their blood glucose targets and simultaneously result in significant weight loss.
The maximum recommended dose of Ozempic for diabetes is now going to be 2 mg. For weight loss, the dose of Wegovy is to remain the same i.e. 2.4 mg weekly subcutaneously.
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Ozempic Dose Escalation for Diabetes:
Ozempic is administered at a dose of 0.25 mg weekly for 4 weeks. This is followed by 0.5 mg weekly for four weeks.
After 8 weeks, the dose is increased to 1 mg weekly for four weeks. If the ADA A1C goals have not been achieved with 1 mg Ozempic, the dose is then increased to 2 mg once a week.
Ozempic Dose | Duration in weeks |
| 0.25 mg | Four weeks |
| 0.5 mg | Four weeks |
| 1 mg | Four weeks |
| 2 mg | Continue |
Ozempic 2 mg dose for Diabetes and 2.4 mg for Weight Loss?
Semalgutide (Wegovy) 2.4 mg has already been approved for the treatment of obesity and overweight individuals with at least one weight-related complication like hypertension, diabetes, and dyslipidemia.
With the approval of Semaglutide 2 mg for uncontrolled diabetes, there is going to be a very minute difference in terms of weight loss between the Ozempic 2 mg dose and the Wegovy 2.4 mg dose.
Obese and non-obese individuals are all going to benefit from the drug. Diabetic patients who are not obese but still wish to lose some weight can easily go up to a dose of 2 mg of Semaglutide.
If prices differ, that could become the only difference between Ozempic 2 mg and Wegovy 2.4 mg. People will try to go for the cheaper alternative.
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In conclusion:
Ozmepic 2 mg dose weekly has shown to be superior in individuals with diabetes compared to the previously approved maximum of 1 mg per week. In addition, it also helps obese diabetic patients to lose extra pounds.
Other drugs currently in the markets or soon going to be approved for diabesity (diabetes and obesity) are:
