Weight-loss jab could ‘eliminate need for insulin injections’ in type 1 diabetes patients

The drug used in a new weight-loss jab could “eliminate the need for insulin injections” in type 1 diabetes patients, a small study has suggested.

The active ingredient, semaglutide, is already used to treat patients with type 2 diabetes and is also available for weight-loss treatment, sold under the names Ozempic and Wegovy, respectively.

The US study, conducted by the University of Buffalo and published in the New England Journal of Medicine, looked at 10 patients who were newly diagnosed with type 1 diabetes between 2020 and 2022.

Type 1 diabetes is less common than type 2 but is a chronic condition that tends to start in childhood and is not linked to age or weight. The body is unable to produce the hormone insulin and so daily injections of it are required to regulate blood sugar levels.

During the study, researchers were able to completely eliminate the need for meal-time insulin doses in all patients after three months, and basal or background insulin doses in seven of the 10 patients after six months.

Their insulin doses were gradually reduced, while semaglutide doses were increased in order to prevent hypoglycaemia when the body’s blood sugar levels dropped too low.

Findings promising for newly diagnosed patients 

Professor Paresh Dandona, senior author of the paper from the University of Buffalo, said: “Our findings from this admittedly small study are, nevertheless, so promising for newly diagnosed type 1 diabetes patients that we are now absolutely focused on pursuing a larger study for a longer period of time.”

He said if the findings can be replicated in larger studies, the research “could possibly be the most dramatic change in treating type 1 diabetes since the discovery of insulin in 1921”.

At diagnosis of type 1 diabetes, the patients had an average HbA1c level - a person’s average blood sugar level over 90 days - of 11.7, which is more than 50 per cent higher than the recommended maximum of seven by the American Diabetes Association.

After six months of treatment with semaglutide and the majority of patients no longer requiring insulin, the average level had fallen to 5.9. After 12 months it was 5.7.

Prof Dandona said: “As we proceeded with the study, we found that even the dose of basal insulin could be reduced or eliminated altogether in a majority of these patients.

“We were definitely surprised by our findings and also quite excited.”

The drug works by activating a specific protein receptor in the pancreas and brain to secrete insulin, which in turn helps to regulate blood sugar levels.

The most common side effects were nausea and vomiting as well as appetite suppression.

The drug’s ability to suppress appetite by mimicking a hormone in the gut so people feel fuller is why it has become popular as a weight-loss drug.

Prof Dandona said a number of patients lost weight but that this was generally an advantage because half of patients in the US with type 1 diabetes are overweight or obese.

However, this is less than the more than two-thirds of the wider population that are overweight or obese in both the US and the UK.

Around 500,000 people in the UK are living with type 1 diabetes.