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Why Is Ozempic Becoming The Most Popularly Prescribed 2nd Tier Treatment For Type 2?

Why Is Ozempic Becoming The Most Popularly Prescribed 2nd Tier Treatment For Type 2?

You can’t watch a TV show without seeing Ozempic or Rybelsus commercials.

So why the big marketing push?

They both belong to the class called GLP-1 Agonists which include Trulicity and Victoza.

The early versions first hit the market in 2006 (Byetta and Bydureon).

Along the way the effectiveness/utility was improved with Victoza (2010), Trulicity (2014), Ozempic (2017) and finally Rybelsus (2020).

Being so "new" none are available as a generic.

Despite a “black box warning” about Thyroid… read more

A DiabetesTeam Member said:

@A DiabetesTeam Member I did leave out a few details on this study (because of space limitations in the post).

All of the test drugs "were in addition to" the patients already taking Metformin which is the always the first drug prescribed (unless you can't tolerate it).

Our blood sugars come from "two sources".

Hepatic Sugars (or metabolic sugars if you like) are made, stored and released by our own body. They are stored/released by the liver so that we have a source of (fuel) when we are not eating since all our organs, brain, muscles and cells constantly need sugar to survive - so we can't rely on food alone.

Metformin helps control "over release" of that Hepatic Sugar but does "nothing" for the sugars we get from eating (Dietary Sugars).

The drugs tested in this study, with the exception of the Long acting Insulin all work on "Dietary Sugars".

They force us to either release extra Insulin (our own) OR try and make it work longer to deal with the sugars that hit our blood after eating.

So Metformin is for fasting sugars, the others are for mealtime sugars.

We have little control over fasting sugars, at least on a day to day basis - it's not like we can just eat less and see a difference tomorrow. While we can cut some carbs and that directly translates into how high our blood sugar goes after eating.

Different types of drugs to treat different things. And you may need "both", one or none, but they do work together to help control "all the sources of sugars" in our blood.

posted 5 months ago
A DiabetesTeam Member said:

@A DiabetesTeam Member Ozempic will not "fix" anything.

Ozempic and the others in it's group are a synthetic hormone that our own body makes itself when we eat.

As food is digested a hormone, GLP-1, is released to tell the pancreas "we need insulin because there is food here". When digestion is done a second hormone, DPP-4, is released to shut the pancreas off.

If we didn't turn it "off" then it would burn up all our blood sugar and we would die.

The Ozempic type drugs just (put/leave) the GLP-1 hormone in our system a little longer so the Pancreas "thinks we are still eating/digesting" when we are actually done.

That keeps the insulin turned on "just a little longer" to help with the extra sugar we have in our system before, ultimately, the DPP-4 shuts it off (so we don't die from low blood sugar).

It can help with weight maintenance or even losing a few pounds because while it's telling the pancreas "food is still there even when it isn't" our brain thinks "we are full" so we are less likely to over eat.

In order to fix the pancreas they would need to find a drug that repairs or regrows the Beta Cells in the pancreas and as of yet there is no such drug.

At the end of the day, any of the drugs, including Ozempic, that force our pancreas to produce more insulin then it would "naturally" are actually "burning it out a little more" then it already is.

That is the price that must be paid when the disease gets advanced or the patient just can't seem to control it with lifestyle alone. The more drugs taken that force the pancreas to release insulin the closer you get to one day needing insulin when it has little left to produce.

But they do keep you alive and that's the choice - die of complications or burn out your pancreas - it is an imperfect world...

posted 2 months ago
A DiabetesTeam Member said:

My initial post was already too long even though I had left out some of the criteria for those in the study.

So for those that are interested, the 5000 that took part were screened for a number of things.

First off they wanted the group to represent the standard demographics - so they were almost exactly 50/50 men/women, 20% were black heritage and 30% were hispanic heritage (both of those groups actually see diabetes rates at double the rest of the population save Native/First Nations which I didn't see included as criteria) and they had to be at least 30 years old.

(I believe I read that the average age of the participants ended up being 57 years old)

Then you had to have been diabetic for 5 years or less, being taking Metformin (but no other Diabetes meds) and have an A1C between 6.8 and 8.5

As I noted above they have only reported the "broad results" and it will likely take another couple of years for the researchers to crunch all the numbers.

But it will be interesting to see if say Women respond better to one drug or Hispanics etc or exactly "how much better" the results were with one over the other.

posted 5 months ago
A DiabetesTeam Member said:

@A DiabetesTeam Member I also have JRA (Juvenile Rheumatoid Arthritis) since age 15 and Fibromyalgia / Raynaud's since age 23. I was on steroids for 40 yrs because I am allergic to all NSAID's. I was also known for hypoglycemia for over 30 yrs while on steroids, so for me to become a diabetic was a surprise to say the least, but in retrospec it should not have been. My Endo sent me to a new Rheumatologist in Oct 2019, as Endo tried new medications on me which landed me in ER after 1 week and ended my nusring career while on sick leave the last 6 months. But the Rheum I saw was fairly young so he is newer in the medical field. He did many Xrays, and MRI of my back and blood tests (I now have OA osteoarthritis and DDD degenerative disc disease. So he slowly weaned me off the steroids as my adrenal glands were lazy from decades of steroids and he had to be sure they would recover. But he also changed and removed or replaced quite a few medications for me. He stated HRT's (hormone replacement therapy for menopaused women) can cause diabetes to worsen, so he took me off them completely in March 2020. The steroids were tapered down from Mid Oct to ending completely on May 6th 2020 (I was on 2.5 mg every other day by that time). The next day he added Plaquenil to the mix stating this was a diabetic friendlier medication for my JRA, and that even in non diabetics it can cause hypos, which it did early on in the treatment. I am on the lowest dose possible due to my body often reacting to medication in the long run and this also gives us room to increase if need be. Up until I got Covid 2 weeks ago my numbers were OK as I have been off all diabetic medications since May 28th 2020, I manage my diabetes with diet. Now the past few days have been rough and sugars are higher thenh my usual, but this is due to my Gastroparesis (and maybe Covid as it takes 3 weeks to develop antibodies after infection so maybe this is playing havoc on my numbers), I know some people in here after the vaccine also had higher numbers while the were also developing antibodies to Covid vaccines, so hoping in a week or 2 it will improve. But the OA had caused my finger to swell up and I had lost function to my hands (another reason I ended my career on sick leave), but about 3 months after the Plaquenil started (it takes up to 3 months for this medication to take effect), but I regained function to both hands and was able to use my hands again. Low Carbs diet helps also with RA at least in my case. Maybe a Rheumatologist might be able to sort things out for you also.

posted 5 months ago
A DiabetesTeam Member said:

I am also on Ozempic and losing weight as well as lowering my A1C to 7.1.
I did have Diarrhea. I am also on Jardiance that causes me to urinate often as it gets rid of glucose via the urination.

posted 5 months ago
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