Living with diabetes means constantly thinking about blood sugar levels, food choices, and medications. Whether you live with diabetes or not, you are likely seeing information about GLP-1 Receptor Agonists (GLP-1s), such as Ozempic or Mounjaro, consuming all of your Instagram content. These medications are showing promise not just for type 2 diabetes, but also in the ongoing efforts to make managing type 1 diabetes easier (although the use of GLP-1s is currently considered off-label for type 1 diabetes).
GLP-1 Receptor Agonists are medications that mimic the action of the GLP-1 hormone. By acting like our natural GLP-1, these medications help with:
For people living with type 2 diabetes, GLP-1s have become a well-established and valuable tool since the early 2000’s. They have been proven to significantly lower A1C levels, and many people with type 2 diabetes find that GLP-1s help them lose weight, which can have a positive impact on overall health and blood sugar levels.
Landmark studies like LEADER, SUSTAIN-6, and others have shown that GLP-1s can reduce the risk of heart problems like heart attack and stroke.
For those living with type 1 diabetes, the idea of using a medication primarily known for type 2 might seem surprising. Since type 1 diabetes is characterized by the body’s inability to produce insulin, insulin therapy currently remains the only treatment option. However, researchers are exploring how GLP-1s might offer additional benefits when taken alongside insulin, such as:
Some people taking GLP-1s may experience nausea, vomiting, or diarrhea, especially when starting the medication. These side effects often improve over time, and there are ways to help manage them.
Ensuring that you consume enough calories and protein while taking GLP-1s is crucial for preventing muscle loss and fatigue. Next time you’re in the dining hall, add some extra protein, such as chicken or eggs, to your plate. If nausea or loss of appetite is preventing you from eating enough, you may need to discuss the need for a lower dose with your healthcare team.
There are also certain conditions, such as a history of pancreatitis or a rare type of thyroid cancer, where GLP-1s might not be the right choice. It’s important to discuss your complete medical history with your doctor before starting these medications.
While GLP-1 medications offer potential benefits, there are some challenges and considerations for people with type 1 diabetes. There is limited long-term data on the safety and effectiveness of GLP-1s specifically for type 1 diabetes, and their use for this population is currently considered off-label. This means they are being used in a manner that differs from what the FDA has approved. Insurance may not cover GLP-1s for type 1 diabetes, making them less accessible and potentially more challenging to afford.
A significant concern for those with type 1 diabetes using GLP-1s is the potential increase in the risk of diabetic ketoacidosis (DKA). DKA is a serious and potentially life-threatening condition.
Anyone with type 1 diabetes taking a GLP-1 should regularly check ketones with urine strips or a blood ketone monitor, especially if experiencing nausea or vomiting.
Another potential issue is the risk of hypoglycemia. Because GLP-1s can lower blood sugar levels, insulin adjustments may be needed to prevent severe hypoglycemia, particularly when starting GLP-1 therapy or increasing the dosage. Make sure to lean on your diabetes care team to help fine-tune your insulin doses as needed.
Careful monitoring of blood sugar levels, ideally with a CGM, is essential for anyone with type 1 diabetes who is using a GLP-1 medication.
In summary, GLP-1 receptor agonists offer many benefits, including improved blood sugar control, weight loss benefits, and cardiovascular protection for those living with diabetes. While their use in type 1 diabetes is still in its early stages, their potential is promising. However, the lack of research, increased risk of DKA, and hypoglycemia risk present some potential challenges for this population.
As research continues, the role of GLP-1 receptor agonists in both type 1 and type 2 diabetes will continue to evolve, providing additional tools to make living with diabetes easier.