Once-a-week Ozempic, GLP-1 receptor agonist, now EU/US approved

Ozempic is a GLP-1 agonist, similar to Trulicity, that requires one injection per week. It was recently approved by the EU, after having passed the FDA hurdles in December: we all missed that:-) Because it was approved as a monotherapy, it can be used on its own (no metformin etc.), with seemingly good results.

As a GLP-1 receptor agonist, it is suitable for use by T2s, but, as we have seen over the past few years, its use may come to be seen by T1s as well. One interesting fact is that it may become available in pill format: it would be the only drug of its class not requiring injection.


@docslotnick, @Gary, do you have any more info on this drug?

This article compares Trulicity and Ozempic. Not a lot of difference between these two GLP-1 agonists in T2, but I’ve yet to see any data on how semaglutide works off label in T1, while dulaglutide has been used in T1’s off label for a while now with good results. However, I don’t really see any reason why semaglutide should not work equally well.



@docslotnick, why does dulaglutide work with T1s?

It seems weird that slowing down glucose absorption from the gut would improve BG control so much:



@Kaelan The benefit of a GLP-1 agonist for the T1 diabetic is that it inhibits post meal glucagon release from the liver. It is beneficial in some T1’s to limit postprandial spikes.


@docslotnick, do you see other benefits than postprandial spikes for a GLP-1 agonist?

I am wondering if some hormonal peaks are possibly primarily glucagon-generated.

I had not heard of Ozempic. I quit paying close attention to GLP-1 products when I started insulin. From what I have read it offers better A1C reduction and more average weight loss. It is also thought to offer cardiovascular benefits.

@Michel GLP-1 agonists also slow absorption of glucose from the gut, which also aids in reducing postprandial spikes. But it seems that its greatest value is for T2’s in not only enhancing insulin production, but also in being protective of beta cells in the pancreas.

I recently saw my endocrinologist and discussed GLP-1 inhibitors. We decided that, because I apparently do not have any overt glucagon response (as evidenced by never having had dawn phenomenon), I would likely be better served staying on an SGLT-2 inhibitor.

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How can you say there is not much difference between Ozempic and Trulicity? Trials has shown that Ozempic leads to a superior blood sugar reduction and more than double the weight loss impact. That is huge in my view.

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