Ozempic and Semaglutide: Breakthroughs in Diabetes and Weight Management

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Ozempic and Semaglutide: Breakthroughs in Diabetes and Weight Management

Context:

Ozempic (semaglutide) has become widely known as a drug for diabetes and weight loss, gaining popularity due to endorsements from public figures like Elon Musk and trending on social media.

More in News:

  • FDA Approvals: The U.S. FDA approved Ozempic in 2017 for type 2 diabetes, followed by Wegovy, another semaglutide injection, in 2021 for chronic weight management in adults with obesity.
  • Manufacturer: Both Ozempic and Wegovy are produced by Danish pharmaceutical company Novo Nordisk.
  • Functionality: Semaglutide is a GLP-1 receptor agonist that simulates a gut hormone (GLP-1), helping reduce appetite, slow digestion, and stimulate insulin release, thereby assisting in weight and glucose control.
  • Availability in India: The oral form (Rybelsus) was introduced in India a few years ago, making it the primary option locally, as injectable forms are yet to be widely available.

Key Features:

  • Weight Loss Benefits: Injectable forms (Ozempic/Wegovy) are shown to help reduce body weight by 10-15%, while oral Rybelsus provides moderate results.
  • Cardio-Renal Benefits: Besides weight loss, semaglutide is noted for its potential heart and kidney health benefits, especially beneficial for diabetes patients at high cardiovascular risk.
  • Usage Guidelines: Doctors primarily recommend semaglutide for diabetes patients, especially those with additional risk factors, and discourage its use as a general weight-loss solution for non-obese individuals.

Adoption & Demand in India:

  • Popularity among patients due to positive word-of-mouth and overseas success stories.
  • Seen as an effective add-on therapy to existing diabetes treatments, especially for those on metformin.
  • Rising interest among patients, but doctors emphasise its primary role in diabetes management, not as a general weight-loss solution.

Challenges & Limitations:

  • Eligibility Criteria: Not everyone qualifies; prescribed primarily for high-risk diabetes patients (e.g., those with cardiovascular risks).
    • Limited to patients for whom weight loss aids in managing diabetes-related complications.
  • Side Effects: Common issues include nausea, bloating, and vomiting; rare cases of stomach paralysis and pancreatitis.
    • Gradual dose increases can help mitigate side effects.
  • Cost Barrier: High costs make it inaccessible for many, with a monthly cost of approximately ₹10,000.
    • The oral form remains prescription-only, with modest sales due to price sensitivity in India.
  • Sustainability & Lifelong Use: Users need to continue the drug lifelong for sustained effects; stopping it can lead to weight regain.
    • Lifestyle modifications are recommended alongside medication to maintain long-term weight loss.

Way forward: 

  • Potential for Broader Use: Studies suggest that semaglutide may benefit a variety of conditions beyond diabetes and obesity, including heart failure, arthritis, Alzheimer’s, and possibly cancer.
  • Indian Market Developments: Indian drugmakers are now preparing to enter the weight-loss drug market, with new options expected soon. The FDA approval of similar drugs by competitor Eli Lilly indicates further developments in this space.
  • Lifelong Commitment: For diabetes patients, semaglutide may require lifelong usage with ongoing dose adjustments, though lifestyle changes could help maintain benefits if treatment is discontinued.
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