Why Semaglutide should be used for people with type 2 diabetes

Semaglutide for weight loss
on Mon 6 Mar

 

Semaglutide – under the brand name Ozempic - has been available to treat people with type 2 diabetes since 2019. It is normally used as part of a diet and exercise program which aims to control the high levels of blood sugar in those with type 2 diabetes

 

It is administered by weekly injection and works by mimicking the action of the satiety-signalling gut hormone GLP1 which increases the release of insulin when blood sugar increases and decreases the amount of sugar generated by your liver.

 

The effect of this is that it helps insulin work better to

  • drive satiety
  • make you feel full and
  • reduce your appetite

 

Semaglutide is proving very effective in reducing weight and blood sugar levels in people with type 2 diabetes. It is proving even more effective in achieving weight loss in those who do not have type 2 diabetes. For that reason you might think that I am pleased to see that Semaglutide - marketed under the brand name of Wegovy – has now been given NHS approval for weight management by NICE (the UK’s National Institute for Health  and Care Excellence) in people with pre-diabetes and those with intractable central weight gain.

 

However,  since prescriptions can simply be issued following the completion of an online form and consultant assessment of that form,  I am concerned that many people will see the drug as a quick fix in their pursuit to lose a few pounds for e.g. a special occasion.

 

There are five main reasons why this bothers me.

 

  1. Side effects

Semaglutide has been rigorously tested on obese people and, although deemed safe to use, is not without several unpleasant side effects in some which include:

  • Nausea
  • Vomiting
  • Diarrhoea
  • Constipation
  • Cramping
  • Acid Reflux

 

This is the reason that the drug should be increased gradually whilst remaining under close specialist guidance.

 

  1. Time Limits

Those in pursuit of treatment for “vanity weight loss” rather than those needing it for health purposes will be tempted to ignore the two year cap on its use which has been set by NICE.

 

NICE has done this as the current data in those without type 2 diabetes does not extend beyond two years and the exit strategy is unclear i.e., how is weight loss maintained thereafter?

 

  1. Weight Regain

Between 2019 and 2021, overweight adults without type 2 diabetes from countries including the UK, the USA, Canada, Japan and Germany took part in a randomised trial of weekly Semaglutide injections. This meant that 328 of them received Semaglutide for 68 weeks. Although the Semaglutide-induced weight loss was significant – over 17% - there was significant weight gain when the injections were stopped – in fact, participants regained 66% of their weight loss in the 12 months following.

 

If you would like to read more about this trial please click here 

 

  1. The body is cleverer than you think

Because our bodies are designed to survive famine, they are compelled to not only regain any weight you lose but also make any future weight loss EVEN more difficult. This can mean that you will gain weight even if you rigorously follow a routine which previously helped you to lose weight

 

  1. Supply Challenges

As the use of Semaglutide by non-diabetics has massively increased, both the UK and the US have experienced shortages which have left patients with type 2 diabetes without a supply

 

For all these reasons I hope Semaglutide does not become regarded as a quick fix weight solution. It may be able to aid those genuinely seeking an understanding as to the triggers which may prompt overeating in the first place; and as a genuine kickstart for those looking to adopt a habitually healthy lifestyle which avoids obesity and its attendant unhealthy consequences. It is possible that in some people this form of medication may be required lifelong to maintain any weight loss achieved.

 

You may be interested in this Times Weekend article about Semaglutide to which I contributed on February 16th 2023

 

Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.

 

As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link

  

Tags: ozempic semaglutide Type 2 Diabetes weightloss

Tags

acanthosis nigricans Acromegaly Addison's disease adolescent diabetes problems adolescent thyroid problems Adrenal crisis adrenal fatigue Adrenal glands Anovulation artificial pancreas Autoimmune Thyroiditis Bariatric Surgery blood glucose levels blood pressure breastfeeding CAH Charcot foot cholesterol CHT coffee cold and flu medications Conception Congenital adrenal hyperplasia congenital hypothyroidism Consultant Endocrinologist London coronavirus cortisol covid-19 Cushing's disease Cushing's syndrome Depression Diabetes diabetes and bone health diabetes and heart health diabetes and oral health diabetes and parkinsons diabetes and sexual dysfunction diabetes and skin conditions diabetes and thrush diabetes in China diabetes insipidus diabetes latest diabetic ketoacidosis diabetic neuropathy Diabetic prevalence diabetic retinopathy diet for diabetes diet for obesity Disability Act Down's Syndrome Dr Mark Vanderpump e-consulting endocrine system fertility folic acid Freestyle Libre frozen shoulder and thyroid Fruit sugars gestational diabetes Gigantism Glucose Monitoring Glucose Tolerance Test gluten free Goitre Graves Disease Graves Orbitopathy guthrie test hair loss Hashimoto's Disease healthcare services hearing loss Heart Disease heel prick test Hepatitis C Hormones - most important how to lose weight hyperparathyroidism Hypersecretion Hyperthyroidism hyperthyroidism and respiratory problems Hypocalcaemia Hypogonadism hypoparathyroidism hypophysitis Hyposecretion Hypothyroidism hypothyroidism and respiratory problems IFG IGT immunotherapy side effects Impaired Fasting Glucose Impaired Glucose Tolerance Insulin Resistance Iodine IR iron Labour and birth late onset hypogonadism Levothyroxine Long Covid losing weight Low testosterone Mark Vanderpump MEN1 MEN2 menopause metabolic syndrome mood changes morning sickness Multiple endocrine neoplasia neuroendocrine tumour neuropathy Obesity obstructive sleep apnoea older patients online doctor OSA Osteoporosis overactive thyroid ozempic Pancreas Pancreatic Cancer Pancreatic Diabetes parathyroid glands Patient Resources Patient Support Groups PCOS PCOS and acne PCOS and fertility PCOS and Insulin PCOS diet Phaeochromocytomas Pituitary Gland POF Polycystic Ovary Syndrome Post menopause thyroid problem Post pregnancy thyroid problem postnatal diabetes medication postnatal thyroid medication Prader-Willi Syndrome pre-eclampsia prediabetes pregnancy Pregnancy and Diabetes Pregnancy and Thyroid Disease Premature Ovarian Failure prolactinomas PTH puberty Radioactive Iodine RAI resistant hypertension semaglutide Sheehan's Syndrome Skin tags sleep and diabetes sleep and obesity soy Soya steroid dependent subacute thyroiditis T4 Tara Palmer Tomkinson testosterone Tetany The endocrine system Thyroid thyroid and menstruation thyroid cancer Thyroid disease in children thyroid nodules Thyroid Storm thyroid tests Thyroiditis Thyrotoxic Periodic Paralysis Thyroxine TSH levels TSH Testing tumours Type 1 diabetes Type 2 Diabetes Type 3 diabetes underactive thyroid Vitamin B complex Vitamin D Waist circumference weight gain weightloss

Please get in touch

Phone: 07565 978310