How Ozempic Is Changing Diabetes Treatment

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Millions of patients rely on insulin. But with new drugs, some have been able to lower their doses or stop taking it altogether.

Millions of Americans rely on some form of insulin, a lifesaving drug that has long been a mainstay of diabetes treatment. But it can also be a burden to patients who must juggle different formulations and doses, and often must have insulin on hand at all times.

“I really feel for those patients, because you can never stop having it in the back of your mind,” said Dr. Scott Hagan, an assistant professor of medicine at the University of Washington who studies obesity.

But in recent years, Ozempic and a similar drug, Mounjaro — both weekly shots that can lower blood sugar, in part by mimicking a hormone that stimulates insulin production — have offered patients an enticing new option to try managing their Type 2 diabetes without relying as heavily on insulin.

And drugmakers are examining other ways these drugs might work alongside insulin: Novo Nordisk, the company that makes Ozempic, is studying a new drug called IcoSema, a weekly shot that combines insulin icodec (an ultra long-acting version of insulin) and semaglutide, the compound in Ozempic.

While it hasn’t yet published the full results, Novo Nordisk has said that promising but preliminary data from two trials suggest IcoSema might lead to better glucose control than insulin or semaglutide alone. Previous trials have suggested that people taking semaglutide or tirzepatide, the substance in Mounjaro, alongside insulin had better blood sugar control and lost more weight than those taking insulin alone.

Patients who are already using these drugs in tandem often do so with the hope of lowering how much insulin they take, or weaning off it altogether. Dr. Hagan said patients are often eager to get off insulin, partly because it can be such a logistical pain, and partly because the medication can lead to weight gain.

There is no standard guidance on how to dose Ozempic and insulin together, though, so doctors said they are learning in real time how to manage patients on both medications. “It’s kind of a moving target,” Dr. Hagan said. Lower a person’s insulin dose too quickly, and their blood sugar might rise out of control.