Dr. Ahmed Ozempic is not recommended for type 1 diabetes. Can you use Ozempic for type 1.5 diabetes? Or can you use Ozempic for type 1 or type 1.5 diabetes with Insulin or other approved medicines?
These are some unanswered questions, but they are not totally illogical. You can use Wegovy, a high-dose Ozempic, purely for weight loss. Why can you not use it for weight loss in Type 1 diabetes or type 1.5 diabetes, along with insulin?
What is Type 1.5 diabetes?
Type 1.5 diabetes is also called “latent autoimmune diabetes of adults” or “late-onset autoimmune diabetes in adults“.
LADA or type 1.5 diabetes is very similar to type 1 diabetes except that patients do not abruptly present with symptoms of diabetes and do not require insulin for at least 6 months after the diagnosis.
Unlike type 1.5 diabetes, patients with type 1 diabetes require insulin from the start. Even most of them are diagnosed when they develop DKA (diabetic ketoacidosis).
The diagnosis of Type 1.5 diabetes is based on the following three criteria:
- Age of the patient: Greater than 35 years
- Presence of autoantibodies: Positive Islet cell antibodies
- Non-insulin-dependent initially: Not requiring insulin for at least six months after the diagnosis
How can we differentiate between Type 1 and Type 1.5 diabetes?
One can not differentiate between type 1 and type 1.5 diabetes, especially once the patients become insulin-dependent.
Here are a few differences between Type 1 and Type 1.5 diabetes [Ref]:
Features | Type 1 Diabetes | Type 1.5 Diabetes |
| Age of onset | Any age but usually younger age (<20 years) | More than 35 years |
| Insulin requirement | From the start | After 6 months of diagnosis |
| ICA (islet cell antibodies) | Positive | Positive |
| Anti-GAD antibodies | Positive | Positive |
| IA-2 antibodies (Islet cell antigen-2) | Positive | Negative |
| Insulin antibodies | Positive | Negative |
| Insulin resistance | Usually absent | Maybe present |
Ozempic for Type 1.5 Diabetes:
Since most patients with Type 1.5 diabetes present after the age of 35 years, it is likely that they are initially labeled Type 2 Diabetics.
In addition, most Type 1.5 diabetics do not require insulin, may have some degree of insulin resistance, and may be obese as well.
All these features may necessitate Ozempic use. Apart from diabetes control, weight loss, and enhancing insulin sensitivity, Ozempic may also slow Beta-cell apoptosis and delay the need for insulin treatment.
One word of caution, if you are Type 1 Diabetic or have been diagnosed as Type 1.5 Diabetic (LADA Diabetes) and on Insulin, DO NOT STOP INSULIN.
You may or may not use Ozempic, but DO NOT STOP USING INSULIN!
If your blood sugars are normal and A1C has dropped to below normal ranges, reduce your insulin dose, but DO NOT STOP Insulin.
If you have stopped insulin and you are doing great, you didn’t have Type 1 Diabetes. You were wrongly labeled.
Recommendation:
Type 1.5 Diabetes is very similar to Type 1 Diabetes. Sometimes people are misdiagnosed as Type 1 or Type 1.5 Diabetes because of their similar presentations.
Insulin is the only treatment for patients who are diagnosed with Type 1 Diabetes. People with Type 1.5 Diabetes also require insulin later in life, usually after the first 6 months.
Ozempic may prevent Beta-Cell Death and hence may be prescribed by your doctor for the treatment of LADA during the early stages. However, once you develop DKA or become insulin-dependent, your only treatment is Insulin.
Some obese people with Type 1.5 diabetes may use Ozempic as an add-on therapy to prevent fluctuations and weight gain, but insulin therapy is THE TREATMENT.
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