Taking Weight Loss Drugs With Type 1 Diabetes Could Come With Hidden Risks, Doctors Warn

Weight-loss medicines like Ozempic, Mounjaro, and different glucagon-like peptide-1 receptor agonists (GLP-1s) have exploded in recognition lately, with practically 15 million People having tried one in some unspecified time in the future. However there’s one group of individuals taking the highly effective medicines that has medical doctors involved: these with sort 1 diabetes.

Each adults and kids with type 1 diabetes are taking GLP-1s greater than they used to, in line with a examine printed in March. The authors attribute the demand to rising weight problems charges amongst folks with sort 1 diabetes, from 30% in 2008 to 38% in 2023.

The Meals and Drug Administration has authorised GLP-1s to handle type 2 diabetes, weight problems, or each (and one, Wegovy, to cut back main cardiovascular occasions for some folks). However none have been green-lit to deal with sort 1 diabetes, additionally generally known as T1D.

In actual fact, prior analysis means that for folks with sort 1 diabetes, the medicines could have harmful penalties.

“Whereas these medicines could supply advantages similar to weight reduction and cardiovascular safety—much like these seen in folks with sort 2 diabetes or weight problems—there are considerations about an elevated danger of hypoglycemia,” or too low blood sugar, mentioned senior examine writer Jung-Im Shin, MD, PhD, an affiliate professor of epidemiology on the Johns Hopkins Bloomberg Faculty of Public Well being.

A persistent situation, sort 1 diabetes most frequently—however not all the time—develops in childhood and is the least widespread sort, affecting as much as 10% of individuals with diabetes.

The illness happens when the pancreas doesn’t produce sufficient insulin, a hormone that helps the physique have power by shifting sugar from the blood to the cells. Left untreated, an excessive amount of sugar within the blood can have devastating penalties, damaging the center, kidneys, nerves, eyes, and extra.

Most individuals with sort 1 diabetes must take insulin photographs or put on an insulin pump. 

Not like sort 2 diabetes, sort 1 diabetes has historically been linked with people who find themselves skinny or common weight.

Nonetheless, obesity charges—particularly amongst Black and Hispanic youth—have been steadily growing amongst folks with a kind 1 diabetes prognosis. For some folks, intensive insulin remedy can contribute to weight acquire. Others would possibly overeat or not train sufficient in an try to keep away from hypoglycemia, a typical complication of the illness. 

“The rise in weight problems charges has led to an elevated curiosity in using this class of drug for chubby and overweight people with T1D,” Marina Basina, MD, a scientific endocrinologist with Stanford Drugs, advised Well being.

Between 2020 and 2023, roughly 17% of overweight youth and virtually 27% of overweight adults with sort 1 diabetes had been prescribed GLP-1s, in line with the brand new examine. Over 60% of these with sort 1 diabetes and GLP-1 prescriptions took liraglutide, semaglutide (the lively ingredient in Ozempic and Wegovy), or tirzepatide, offered below the model names Zepbound and Mounjaro.

In keeping with Shin, GLP-1 medicine are designed to decrease blood sugar ranges by stimulating insulin manufacturing and suppressing secretion of the hormone glucagon, which raises blood sugar ranges (and likewise slows digestion and curbs urge for food).

The medicines can supply advantages for folks with sort 2 diabetes, similar to enhancing glycemic management, insulin exercise, curbing post-meal blood sugar spikes, and defending the center and kidneys, Basina mentioned. Nonetheless, she famous that there hasn’t been sufficient analysis to find out whether or not GLP-1s have an effect on folks with sort 1 diabetes in the identical method. 

Analysis has discovered solely that liraglutide—taken as soon as day by day—improved glycemic management, weight reduction, and insulin exercise in folks with sort 1 diabetes. However researchers additionally found that it raised the chance of two situations: hypoglycemia and hyperglycemia with ketosis, which is excessive blood glucose with the presence of excessive ranges of ketones, a kind of acid the physique makes when it makes use of fats as a substitute of glucose for power.

Hypoglycemia can happen when a GLP-1 is utilized in mixture with insulin. “The mixed impact can decrease blood sugar an excessive amount of, which can result in hypoglycemia,” Shin advised Well being. However when somebody lowers their insulin dose whereas on a GLP-1, as some medical doctors could recommend, that might result in the other downside—excessive blood sugar.

Shin mentioned that it’s pressing that researchers examine the well being dangers of taking GLP-1s in folks with sort 1 diabetes, particularly as a result of many are already taking them. Longer and bigger potential research are wanted to tell scientific steerage about how this inhabitants can safely use GLP-1s, Basina mentioned.

Within the meantime, it’s essential for physicians—and sufferers with sort 1 diabetes—to weigh the dangers and advantages and monitor for uncomfortable side effects in the event that they select to take GLP-1s. “It’s vital to let sufferers know that though the medicine have been very efficient within the brief time period, the long-term information on the advantages and dangers isn’t nicely established,” Basina mentioned.