Karmactive Staff
A new study reveals that Ozempic, a drug widely known for treating type 2 diabetes, may also benefit people with type 1 diabetes who struggle with weight issues. In a groundbreaking clinical trial published in NEJM Evidence on June 23, 2025, researchers found that semaglutide—the active ingredient in Ozempic—improved blood sugar control and reduced weight in adults with type 1 diabetes and obesity.
Led by Dr. Viral Shah of Indiana University School of Medicine, the 26-week study involved 72 adults with type 1 diabetes who were using automated insulin delivery (AID) systems and had a body mass index of 30 or higher. Half received weekly semaglutide injections while the other half got a placebo, with all participants continuing their regular insulin therapy.
The results were striking: 36% of patients in the semaglutide group achieved all three of the study’s goals—maintaining blood sugar in the target range more than 70% of the time, experiencing dangerously low blood sugar less than 4% of the time, and losing at least 5% of their body weight. Not a single patient in the placebo group met all these criteria.
“For a hundred years, we are fixated on insulin and insulin delivery…and there aren’t really extra medications that are approved for type 1,” Dr. Shah told reporters. The semaglutide group lost an average of 20 pounds (9 kg) during the study period, with no increase in diabetic ketoacidosis events reported.
The potential benefits extend beyond weight loss. Many people with type 1 diabetes develop what doctors call “double diabetes”—where insulin deficiency (the hallmark of type 1) is complicated by insulin resistance and obesity, problems typically associated with type 2 diabetes.
Dr. Melissa-Rosina Pasqua, endocrinologist at the MUHC and doctoral student at The Institute, described it as “an important stepping stone in demonstrating the benefits of this drug.” However, he cautioned that more evidence is needed before regulatory agencies would approve the medication for type 1 diabetes.
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Semaglutide works by mimicking a hormone called GLP-1 that the body naturally produces after eating. This helps control blood sugar by increasing insulin release when needed, slowing stomach emptying, and reducing sugar production by the liver. In people with type 1 diabetes, where the body doesn’t produce insulin, semaglutide can still help by improving insulin sensitivity, suppressing the hormone glucagon (which raises blood sugar), and promoting weight loss.
Importantly, the study found no serious safety concerns with semaglutide use in this patient group. There were two cases of severe hypoglycemia in both the treatment and placebo groups, suggesting the drug didn’t increase this risk. However, researchers did note the need to monitor for high ketone levels, a potential concern in type 1 diabetes.
Currently, Ozempic is not FDA-approved for type 1 diabetes. Dr. Shah hopes their trial will encourage pharmaceutical companies to conduct larger regulatory approval studies so the drug could become available as an adjunct to insulin therapy.
This research offers hope to the growing number of people with type 1 diabetes who also struggle with weight management—potentially giving them the first significant treatment advance beyond insulin in a century.
It’s worth noting that patients considering Ozempic should be aware of potential side effects reported in other studies, including rare cases of vision problems and dental issues such as dry mouth. As with any medication, patients should discuss the full range of benefits and risks with their healthcare provider.
Frequently Asked Questions
Ozempic (semaglutide) is a GLP-1 receptor agonist medication primarily approved for Type 2 diabetes. For Type 1 diabetes, it works differently than insulin by slowing digestion, improving insulin sensitivity, suppressing glucagon (which raises blood sugar), and promoting weight loss. It doesn’t replace insulin but can work alongside it as a complementary treatment, especially for Type 1 diabetes patients who also struggle with obesity and insulin resistance.
No, Ozempic is not currently FDA-approved for Type 1 diabetes. It’s only approved for Type 2 diabetes, reducing cardiovascular risks in people with Type 2 diabetes and heart disease, and for chronic weight management (under the brand name Wegovy). The research discussed in this article represents new findings that might eventually lead to FDA approval for Type 1 diabetes, but larger clinical trials would be needed first.
The study found that 36% of Type 1 diabetes patients who received Ozempic achieved all three treatment goals: maintaining blood sugar in the target range more than 70% of the time, experiencing low blood sugar less than 4% of the time, and losing at least 5% of body weight. None of the patients in the placebo group achieved all these goals. On average, patients taking Ozempic lost about 20 pounds (9 kg) during the 26-week trial.
“Double diabetes” refers to when people with Type 1 diabetes (an autoimmune condition where the body doesn’t produce insulin) also develop insulin resistance and obesity typically associated with Type 2 diabetes. Ozempic helps address this by improving insulin sensitivity, promoting weight loss, and helping to control blood sugar through mechanisms beyond just replacing insulin. This is particularly important as obesity rates among Type 1 diabetes patients have been increasing significantly.
The study found no increase in diabetic ketoacidosis (DKA) and similar rates of severe hypoglycemia between the Ozempic and placebo groups. However, patients should be monitored for high ketone levels. Common side effects of Ozempic include nausea, vomiting, diarrhea, and abdominal pain. There are also some reports of rare side effects such as vision problems and dental issues with long-term use. Anyone considering Ozempic should discuss all potential risks with their healthcare provider.
There is no specific timeline yet for when Ozempic might be approved for Type 1 diabetes. Researchers hope this initial study will encourage pharmaceutical companies to conduct larger regulatory approval trials. If successful, Ozempic could potentially become the first significant non-insulin medication approved specifically for Type 1 diabetes. The approval process typically takes several years as it requires extensive clinical trials to establish safety and efficacy for this new use.
