Dr. Ahmed For adults who live with both Type 1 Diabetes (T1D) and obesity, balancing blood sugar levels while trying to manage weight can feel like a constant battle.
But a recent study published in NEJM Evidence gives new hope. It shows that semaglutide, a drug that is already used for other conditions, might help with both serum sugar control and weight loss in these patients.
Semaglutide is better known by brand names like Ozempic, Wegovy, and Rybelsus. It belongs to a group of medications called GLP-1 receptor agonists, which are already approved for treating Type 2 Diabetes and obesity.
However, its role in treating Type 1 Diabetes had not been seriously studied. This research is the first clinical trial to examine whether semaglutide could help adults with T1D who are also overweight, particularly those who use automated insulin delivery systems (smart pumps that adjust insulin levels automatically).
Read: Can Patients with Type 1 Diabetes Use Ozempic?
Type 1 Diabetes and Obesity
Type 1 Diabetes is an autoimmune problem where the body attacks its own insulin-producing cells, making it impossible to produce insulin naturally.
People with T1D must take insulin daily to stay alive. But while insulin is life-saving, it can sometimes lead to weight gain. This can be especially challenging for people who are already overweight or obese.
Having both T1D and obesity increases the risk of serious health issues like heart disease, kidney issues, and nerve damage.
Managing both conditions at once is difficult, and patients and doctors are always looking for better solutions that do not make one condition worse while treating the other.
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Methodology and Analysis:
The study included 72 adults over a 26-week period across several medical centers. It was a double-blind trial, which means neither the patients nor the doctors knew who was getting semaglutide and who was receiving a placebo (actually a fake drug).
This type of study helps remove bias and makes the results more trustworthy. All the participants had type 1 diabetes, a body mass index (BMI) of 30 or above, and were using automated insulin pumps to manage their blood sugar.
So, about 36% of those who took weekly doses of semaglutide reached three major health goals:
- They spent over 70% of their day with blood sugar levels in the ideal range (70 to 180 mg/dl), helping prevent both high and low sugar episodes.
- They spent less than 4% of their time with low blood sugar, reducing the risk of dangerous drops.
- They lost at least 5% of their body weight, which is considered clinically important. In comparison, none of the people in the placebo group achieved all three of these health goals.
The semaglutide group lost around 18.5 to 20 lbs over six months, which is a major improvement.
Moreover, the weight loss and better sugar control did not lead to an increased risk of severe low blood sugar or diabetic ketoacidosis, both serious complications that often worry patients and doctors when trying new treatments.
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Why Semaglutide Might Work for T1D with Obesity
Semaglutide works in several ways that can help both with blood sugar and weight:
- It slows down how fast food moves from the stomach to the intestines. This makes people feel full for longer, which helps them eat less and lose weight.
- In people with Type 2 Diabetes, it increases insulin and lowers sugar production in the liver. But in T1D, where people don’t make insulin, its benefits likely come from slowing digestion and possibly making the body more sensitive to insulin.
- It acts on the brain to lower hunger and food cravings, further supporting weight loss.
For people already taking insulin, adding semaglutide could reduce the total insulin they need, improve blood sugar stability, and help with managing their weight, a win-win situation.
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The bottom line:
Even though the results look promising, semaglutide is not yet approved for people with Type 1 Diabetes.
This study is an early step, and more long-term, larger-scale research is needed before doctors can prescribe it routinely for this group.
Nevertheless, this study changes the conversation. Until now, people with T1D haven’t had many options to manage their weight safely.
This research shows that adding semaglutide to their insulin treatment may be a game changer.
If larger studies confirm these results, semaglutide could become a powerful “add-on” treatment that targets both blood sugar and weight, two of the biggest struggles for people with T1D and obesity.
The researchers are hopeful that this data will motivate drug companies and funding agencies to launch bigger trials, so that regulatory bodies like the FDA can consider approving semaglutide for this new use.
If approved, it could become a vital tool to improve quality of life, prevent long-term health problems, and give new hope to many people living with the dual challenge of Type 1 Diabetes and obesity.
In short, this study doesn’t provide all the answers, but it opens a very important door. The path forward looks brighter, and for many patients, that’s a reason to be optimistic.
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