GLP1 (Glucagon-like peptide 1) is a hormone, which belongs to the group of Incretin hormones, found in the human gut. This plays an important role in our metabolism, especially the glucose metabolism.

The natural GLP-1 is broken down in the circulation within minutes and is therefore not to be used as a medicine. On the other hand, modern GLP-1 receptor agonists (GLP-1RA) have a clear prolonged effectiveness and can be used once a day, some also administered only once a week.

GLP-1 receptor agonists are particularly effective at lowering glucose levels without causing hypoglycemia. In addition, they effectively reduce body weight and blood pressure and improve the lipid profile.

What is Semaglutide (Ozempic, Rybelsus, Wegovy) and how is it used?

Semaglutide , in the market under the 1 weekly injection Ozempic/Wegovy or daily tablet Rybelsus, belongs to the group of GLP1’s.

Ozempic was approved as a weekly injection under the skin first 2017 for treatment of Diabetes Type 2 patients, 2018 the daily tablet form Rybelsus with same indication came out and 2021 Wegovy 1, a weekly injection under the skin, was approved for Obesity patients.

What are the effects of Semaglutide (Ozempic, Rybelsus, Wegovy)?

GLP-1’s like Semaglutide promote the release of insulin, a hormone that lowers blood sugar levels. At the same time, GLP-1 inhibits the release of glucagon. This opponent of insulin increases the sugar levels in the blood vessels.

It has series of extrapancreatic effects:

• Leads to delayed Gastric emptying
• Intervenes in energy balance
• Promotes the feeling of satiety
• Influence on eating behaviour and sleep rhythm at the central level

Studies have shown an average of HBA1 reduction between 1-2 % over an average of 40 weeks for Ozempic, Rybelsus.

Studies have shown for Wegovy, an average weight reduction of 15% over 68 weeks.

Am I eligible for Semaglutide (Ozempic, Rybelsus, Wegovy)?

The indications are following as per ADA 2022 guidelines:

Ozempoic and Rybelsus: Diabetes Type 2 patients

• With Heart and Kidney disease

• With Obesity

• who take insulin: combine insulin with a GLP-1 receptor agonist if additional glucose lowering is needed, as opposed to only increasing insulin dosing

Wegovy:

• A BMI of 30 kg/m² or greater (obesity) or
• A BMI of at least 27 kg/m² but less than 30 kg/m² (overweight) who have weight-related health problems (such as diabetes, high blood pressure, abnormal levels of fats in the blood, breathing problems during sleep called ‘obstructive sleep apnoea’ or a history of heart attack, stroke or blood vessel problems).

What are Side effects and contraindications for Semaglutide (Ozempic, Rybelsus, Wegovy)?

Side effects:

Very common (may affect more than 1 in 10 people)

• Feeling sick (nausea) – this tends to subside over time
• Diarrhea – this usually subsides over time

Common (may affect up to 1 in 10 people)

• Vomit
• Low blood sugar (hypoglycaemia) when using this medicine with another medicine for diabetes
• Indigestion
• Inflammation of the lining of the stomach (“gastritis”) – signs include stomach pain, feeling sick (nausea) or being sick
• Heartburn – also called “gastroesophageal reflux disease” (GERD).
• Stomach pain
• Bloated stomach
• Constipation
• Burping
• Gallstones
• Dizziness
• Fatigue
• Weight loss
• Reduced appetite
• Bloating (flatulence)
• Elevation of pancreatic enzymes (such as lipase and amylase)

Uncommon (may affect up to 1 in 100 people)

• Changes in taste sensation
• Fast pulse
• Injection site reactions – such as B. bruising, pain, skin irritation, itching and rash
• Allergic reactions such as rash, itching or hives

Serious side effects:

Common (may affect up to 1 in 10 people)

• Complications of diabetic eye disease (retinopathy) – you should tell your doctor if you develop eye problems such as B. get blurred vision.

Uncommon (may affect up to 1 in 100 people)

• Inflamed pancreas (acute pancreatitis) which can cause persistent, severe pain in your stomach and back. See a doctor straight away if you notice these symptoms.

Rare (may affect up to 1 in 1,000 people)

• Severe allergic reactions (anaphylactic reactions, angioedema). You should get medical help right away and tell your doctor right away if you experience symptoms such as B. have trouble breathing, swelling of the face, lips, tongue and/or throat with difficulty swallowing and rapid heartbeat.

Contraindications:

• Personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2
• Known hypersensitivity to Semagluitde or any of the product components
• Age under 18 years
• pregnancy and breastfeeding period