How Does Ozempic Work?

Ozempic is among some of the newer medications used to treat type 2 diabetes. 

According to studies, ozempic can help improve blood sugar levels, promote weight loss, and offer cardioprotective benefits.

But how does ozempic work? Keep reading to find out.

What is Ozempic?

Ozempic is a brand name for a drug called semaglutide, which the FDA approved in 2017. Ozmepic is in a class of medications called GLP-1 receptor agonists. 

Notably, ozempic is a non-insulin injectable medication used to treat type 2 diabetes. Ozempic isn’t for people with type 1 diabetes.

Ozempic comes in prefilled injector pens. The typical dose of Ozempic is 0.25 milligrams once weekly for four weeks, then 0.5 milligrams weekly for at least four weeks. If blood sugar targets aren’t met with 0.5 milligrams weekly, the dose can gradually increase to 2 milligrams weekly.

How does Ozempic work?

GLP-1 is a hormone that increases insulin secretion and slows stomach emptying. GLP-1 receptors in your pancreas help increase insulin secretion while reducing glucagon secretion, a hormone that raises blood sugar levels. So, GLP-1 receptor agonists like Ozempic activate these receptors to help lower blood sugar levels.

The hormone GLP-1 plays a role in regulating appetite. Studies show that appetite hormones can be altered in people who are considered overweight or obese, which means they might feel more hungry compared to leaner people. 

In obese subjects, GLP-1 receptor agonists like Ozempic appear to restore a hormone activation pattern more similar to lean patients, which is one of the ways it might help you lose weight.

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What can Ozempic be used for?

So far, the FDA has only approved Ozempic to treat type 2 diabetes and reduce the risk of cardiovascular disease in patients with diabetes. 

Some healthcare providers might use medications “off label.” This is when they prescribe medication for another condition other than what the medication is intended for.

Ozempic for type 2 diabetes

Ozempic is a newer medication for type 2 diabetes. GLP-1 receptor agonists like Ozempic are becoming more popular because they tend to be effective, can promote weight loss, and don’t come with a risk of low blood sugar (hypoglycemia) like insulin does.

In a 2021 study, patients with a mean baseline hemoglobin A1c of 8.9% were given Ozempic at doses of either 1 milligram or 2 milligrams weekly for 40 weeks. After 40 weeks, the mean reduction in A1c for those taking 1 milligram weekly of Ozempic was 1.9% and 2.2% for those taking 2 milligrams of Ozempic weekly.

A reduction of around 2% in hemoglobin A1c is significant. In terms of average blood glucose levels, that would equate to your average blood sugar going from 209 mg/dL to 151 mg/dL.

When comparing ozempic vs metformin, ozempic appears to be more effective than metformin, a popular diabetes drug that has been approved to treat diabetes since the 1990s. Ozempic can also be used along with metformin to improve blood sugar levels. 

Ozempic for weight loss

It’s important to note that Ozempic isn’t approved as a weight loss medication. Another drug with the brand name Wegovy, which has the same active ingredient as Ozempic (semaglutide), is approved as a weight loss drug

Even though Ozempic isn’t approved solely for weight loss, it might help you lose weight. Ozempic can promote weight loss by slowing gastric emptying, which means you’ll feel fuller after eating than you used to. Ozempic also acts on appetite-regulating hormones to reduce your appetite, aiding in weight loss.

There are a few studies on ozempic weight loss results. In a study on over 1,900 people (without diabetes) considered overweight or obese, taking 2.4 milligrams of Ozempic weekly resulted in an average weight loss of nearly 15% compared to 2.4% with the placebo group.

According to a 40-week trial on people with type 2 diabetes who were also taking metformin, people taking 1 milligram of Ozempic weekly lost an average of 12.8 pounds (average starting weight of 211 pounds) or around 6% of their body weight.

Ozempic for PCOS

Polycystic ovary syndrome, or PCOS, is a hormonal imbalance when a woman’s ovaries produce too many androgens, a type of male sex hormone. The ovaries also form small fluid-filled sacs called cysts. 

Polycystic ovary syndrome is one of the leading causes of infertility in women. High levels of androgens can make it difficult to ovulate, which is when an egg is released to be fertilized. PCOS patients typically have long, irregular menstrual cycles since they don’t ovulate very often.

The main cause of PCOS is insulin resistance, the driving factor behind type 2 diabetes. Women with PCOS might be at higher risk of developing type 2 diabetes and, therefore, may benefit from a medication like Ozempic.

Ozempic isn’t approved to treat PCOS. If it’s used off-label, Ozempic might improve some of the symptoms of PCOS by promoting weight loss and improving insulin resistance, which can improve PCOS symptoms.

Ozempic for prediabetes

Prediabetes is a condition where your blood sugar levels are higher than normal but not high enough to be diagnosed with diabetes. Like type 2 diabetes, prediabetes stems from insulin resistance. 

Insulin resistance occurs when your body doesn’t respond to the hormone insulin effectively. Insulin helps lower blood sugar levels, which is why insulin resistance causes high blood sugar levels.

If prediabetes is left untreated, it can develop into type 2 diabetes within five years. Prediabetes often has no symptoms, so it’s important to be screened for blood sugar problems, especially if you’re at higher risk.

Results from test tube and animal studies suggest that GLP-1 receptor agonists like Ozempic combat insulin resistance by reducing markers of inflammation, which can fuel insulin resistance.

Losing weight can improve insulin sensitivity and can help lower blood sugar levels. Losing 5-10% of your initial body weight can help prevent prediabetes from turning into diabetes. For a 200-pound person, that would equate to a 10-20 pound weight loss.

Because Ozempic can help you lose weight and improve insulin resistance, it theoretically could be an effective tool for managing prediabetes

Ozempic isn’t approved to treat prediabetes, so it might be difficult to get Ozempic prescribed or covered by your insurance company for that reason. 

Ozempic for cardiovascular health

Drugs like Ozempic can offer cardioprotective benefits, which help reduce your risk of cardiovascular disease, including heart attack and stroke. 

The likely reason is due to improvements in blood sugar levels, blood pressure levels, and weight reduction that can be obtained from using drugs like Ozempic.

In 2017, the FDA approved Ozempic for its potential to reduce the risk of stroke, heart attack, and other major adverse cardiovascular events in adults with type 2 diabetes and heart disease. 

It’s unclear how beneficial Ozempic would be for heart health in people without diabetes since the studies and FDA approval are specifically for adults with type 2 diabetes and heart disease.

Can Ozempic be used in type 1 diabetes?

Ozempic isn’t intended to be used to treat type 1 diabetes, nor is it approved to do so. However, some clinical trials are exploring the potential benefits of using GLP-1 receptor agonists like Ozempic in addition to insulin to reach blood sugar goals.

Ozempic can’t effectively treat type 1 diabetes because patients with type 1 diabetes can’t make insulin, so they must inject it several times per day to manage their blood sugar levels. 

GLP-1 receptor agonists like Ozempic help increase insulin production, which wouldn’t be effective in people with type 1 diabetes since their pancreatic cells that make insulin (beta cells) have been destroyed. 

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How long does Ozempic take to work?

How long it takes Ozempic to start to work will depend on many factors, such as your dosage, baseline health conditions, and tolerance to the medication.

When Ozempic is first prescribed, the dose is very low to help your body get used to it. Over time, the Ozempic dose will gradually be increased until you reach a therapeutic dose that helps you meet your blood sugar goals. 

Following the gradual initial dosing schedule, it will take around eight weeks to reach a dose of 0.75 milligrams weekly. Since 2 milligrams is the maximum dose, it will likely take at least 1-2 months to start to notice the effects of Ozempic, and even longer if you need to keep increasing the dose.

Can you take Ozempic long-term?

Ozempic is a medication designed to be used long-term to manage type 2 diabetes. Since Ozempic has only been around for several years, there is a chance that potential issues from taking it longer term might arise. The longer a medication has been used, the more is learned about its long-term safety and risks.

Because of the potential risks of rare but serious complications like thyroid tumors, you should monitor your health closely while taking prescription medications like Ozempic. All drugs come with potential risks, so Ozempic isn’t unique in this way.

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How to increase the effectiveness of Ozempic

  • Take Ozempic as prescribed to increase its effectiveness. Taking too little Ozempic or skipping doses regularly won’t provide the same results as if you took it as prescribed.
  • Monitor your blood sugar levels to assess how well Ozempic works for you. If your blood sugar levels still aren’t on target, your healthcare provider might suggest increasing your Ozempic dose to boost its effectiveness.
  • Don’t forget the importance of maintaining healthy lifestyle habits. Eating a healthy diet while taking Ozempic and being physically active can greatly improve your blood sugar levels, promote weight loss, and improve your health in other ways.

Conclusion

Ozempic works to lower blood sugar levels by boosting levels of GLP-1, which improves insulin resistance, boosts insulin secretion, and promotes weight loss.

While it’s not approved as a weight loss drug, Ozempic can promote weight loss by slowing gastric emptying and influencing hormones that impact appetite.

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Sources

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  2. Frías JP, Auerbach P, Bajaj HS, Fukushima Y, Lingvay I, Macura S, Søndergaard AL, Tankova TI, Tentolouris N, Buse JB. Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial. Lancet Diabetes Endocrinol. 2021 Sep.
  3. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar.
  4. Moran LJ, Lombard CB, Lim S, Noakes M, Teede HJ. Polycystic ovary syndrome and weight management. Womens Health (Lond). 2010.
  5. Guo C, Huang T, Chen A, Chen X, Wang L, Shen F, Gu X. Glucagon-like peptide 1 improves insulin resistance in vitro through anti-inflammation of macrophages. Braz J Med Biol Res. 2016 Nov.
  6. Jia X, Alam M, Ye Y, Bajaj M, Birnbaum Y. GLP-1 Receptor Agonists and Cardiovascular Disease: a Meta-Analysis of Recent Cardiac Outcome Trials. Cardiovasc Drugs Ther. 2018.
  7. Clinical Trials. Weekly Subcutaneous Semaglutide as Adjunct to Closed-loop Therapy in Type 1 Diabetes Care (SEMA-AP).
  8. MacDonald PE, El-Kholy W, Riedel MJ, Salapatek AM, Light PE, Wheeler MB. The multiple actions of GLP-1 on the process of glucose-stimulated insulin secretion. Diabetes. 2002 Dec. 

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