Introduction
In recent years, semaglutide, sold under brand names like Ozempic and Wegovy, has gained significant attention as a treatment for type 2 diabetes and weight management. Initially approved in 2017 by the United States Food and Drug Administration (FDA) for type 2 diabetes, semaglutide’s injectable form, Wegovy, received approval in 2021 for chronic weight management in adults with obesity or other weight-related health conditions. Celebrities like Elon Musk have publicly discussed using it, sparking a wave of interest and even “Ozempic parties.” However, its rising popularity has caused supply shortages in several regions.
What is Semaglutide?
Semaglutide belongs to the class of drugs known as Glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs mimic the natural hormone GLP-1, which the small intestine releases after eating. The primary functions of semaglutide include:
- Slowing down digestion
- Reducing appetite
- Stimulating insulin release from the pancreas
As a result, semaglutide aids in weight loss and offers heart and kidney benefits. Dr. V. Mohan, chairman of Dr. Mohan’s Diabetes Specialities Centre in Chennai, notes that the drug is available as an oral tablet (Rybelsus) and injectable forms (Ozempic/Wegovy). While the injectables often lead to greater weight loss, their availability in India remains limited.
Rising Interest in India
India has a high prevalence of diabetes, with an estimated 10.13 crore patients, as well as significant rates of abdominal obesity (40% among women and 12% among men). This has generated significant interest in semaglutide, though cost and potential side effects remain barriers to widespread use.
Semaglutide’s Effectiveness in Diabetes Control
Patient Experiences and Physician Insights:
Doctors across India have observed notable results in diabetes management and weight loss among patients prescribed semaglutide. Dr. Anoop Misra from Fortis CDOC Hospital for Diabetes in Delhi reports a growing demand for Rybelsus, fueled by awareness from abroad. However, experts caution that semaglutide is primarily intended for diabetes management, with weight loss as a secondary benefit.
Dr. Mathew John, an endocrinologist in Thiruvananthapuram, emphasizes that diabetes is complex and requires holistic care. Semaglutide, with its benefits for renal, cardiovascular, and hepatic health, should not be viewed solely as a weight-loss drug. Eligibility for the drug is also selective; Dr. Mahesh D. M. from Bengaluru notes that only a small portion of interested patients receive prescriptions due to specific health criteria.
Dr. Akhil Krishnan from Kimshealth in Thiruvananthapuram further adds that semaglutide is most effective when combined with a healthy diet and exercise. The drug works well for many patients, though some do not experience its full benefits.
Common Side Effects and Tolerability
Since semaglutide acts on the digestive system, common side effects include bloating, nausea, and vomiting. Rare cases may lead to severe complications such as stomach paralysis or pancreatitis. Dr. K.V.S. Hari Kumar from Hyderabad estimates that 5-10% of patients discontinue the drug due to intolerable side effects.
Real-Life Patient Stories
Successful Experiences
- Arundati from Hyderabad reported losing 10-12 kg over six months while taking semaglutide, with initial nausea subsiding over time.
- Saumya from Hyderabad experienced significant weight loss after struggling with intermittent fasting. She managed to stabilize her blood sugar levels, despite facing mild acidity.
Cases of Side Effects and Challenges
- Gopi from Thiruvananthapuram faced difficulties managing the regimen due to gastric issues but hopes to resume treatment soon.
- Chitra, a 38-year-old with a high BMI and gallbladder issues, developed pancreatitis after starting semaglutide, highlighting the need for careful medical oversight.
Dose Management and Recommendations
Doctors often begin patients on a low dose of semaglutide to minimize side effects and gradually increase the dosage. Dr. K. Jothdev, who manages several diabetes centers, notes that starting at 3 mg helps reduce insulin use and supports weight loss.
Addressing India’s Obesity Crisis
Obesity affects approximately 24% of women and 23% of men in India, according to the National Family Health Survey 5. Dr. S. Chandrasekar from Government Stanley Medical College states that losing even 15% of body weight can significantly improve diabetes management. However, experiences vary; while some patients achieve meaningful weight loss and improved health metrics, others face challenges related to cost and tolerability.
Cost Considerations and Accessibility Barriers
The cost of semaglutide, particularly the oral form Rybelsus, poses a barrier for many patients. Prices range from ₹3,170 to ₹3,870 for ten tablets, leading to monthly expenses of around ₹10,000 at the lowest dosage. High out-of-pocket health expenditures in India further complicate access. Despite its prescription-only status, a black market has emerged, presenting risks for self-medication and unsupervised use.
Lifelong Commitment and Potential Reversal
Patients must continue using semaglutide long-term, as discontinuation may lead to weight regain. Dr. Subrata Das from Sakra World Hospital emphasizes the importance of lifestyle changes alongside treatment to maintain benefits.
The Future of Semaglutide and Related Research
Research is underway to explore semaglutide’s potential in treating various illnesses, including heart failure, arthritis, Alzheimer’s, and even nicotine dependence. However, those in India seeking the injectable form may face long waits due to regulatory and availability challenges. Novo Nordisk’s Wegovy has not yet been approved in India, and Eli Lilly’s alternatives, such as Mounjaro/Zepbound, are pending final approval.
Conclusion
Semaglutide offers promising outcomes for diabetes and weight management, but it is not without challenges. Cost, accessibility, and side effects must be carefully weighed, and patients require proper medical supervision. As interest in semaglutide continues to grow, its impact on obesity and diabetes management in India will likely expand, offering hope to many patients while raising important considerations for equitable access and safe use.
Source : – The Hindu
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