Has semaglutide transformed treatment of diabetes and obesity in India?

Ozempic, Wegovy, and semaglutide: The wonder drugs for diabetes and weight loss, with benefits and side effects explained.

A few years ago, one word began to do the rounds amongst people with diabetes and those struggling to lose weight: Ozempic. Touted as a wonder drug, it soon took the world by storm. Celebrities such as Elon Musk revealed that they had used it. Reports of “Ozempic parties” followed, and, as the drug’s popularity surged, supply became a drag in various countries.

Ozempic, known generically as semaglutide, is an injectable prescription drug. It was approved in 2017 by the United States Food and Drug Administration (FDA) for use in adults with type 2 diabetes. In 2021, the FDA approved of another injectable semaglutide, Wegovy, for chronic weight management in adults with obesity/overweight and with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol). Ozempic and Wegovy are manufactured by Danish drugmaker Novo Nordisk.

So what is semaglutide and who uses it in India? Semaglutide belongs to the class of drugs called Glucagon-like peptide-1 (GLP-1) receptor agonists. This drug mimics the actions of the hormone GLP-1 made by the small intestine, which the gut releases after eating. What this does is slow down digestion and reduce the appetite, while triggering the pancreas to release more insulin.

The use of the drug therefore, leads to weight loss, and some benefits to the heart and kidney have also been noted, explains V. Mohan, chairman of Dr. Mohan’s Diabetes Specialities Centre, Chennai.

Semaglutide is available in oral (Rybelsus) and injectable (Ozempic/Wegovy) forms. The injectables result in weight losses of about 10 to 15% in patients, Dr. Mohan says. “The daily oral tablet (Rybelsus), which was launched in India a few years ago, is a breakthrough, though it cannot be compared with the effectiveness of the injectable forms that are still not available in the country,” he says.

In a country that has an estimated 10.13 crore people with diabetes and where the prevalence of abdominal obesity is estimated to be 40% among women and 12% in men, a drug like semaglutide has attracted widespread interest, though costs remain a significant barrier to its use, while side effects deter some patients.

Doctors across India have been prescribing oral semaglutide to patients for two years now, and say they have seen results in terms of diabetes control and weight management.