Has Ozempic and its glucagon-like peptide 1 (GLP-1) next of kin found their place alongside Swiss army knives and jacks of all trades? A new report published by the Journal of American Medical Association brings to light that very possibility.
Luba Yammine, an associate professor in the department of psychiatry and behavioral sciences at UTHealth Houston, discovered that when she prescribed GLP-1 to treat patients with type 2 diabetes, a certain number of her patients quit smoking.
“That sort of prompted my dive into the literature [studies of those medications],” Yammine said.
And what did she find? Not only could these medications be a game-changer for smokers trying to quit, but once someone does kick their nicotine habit, they could also prevent the inevitable weight gain that often comes with ditching cigarettes.
Kick more habits, too
On top of the promise that those drugs hold for Type 2 diabetes, smoking cessation, and weight loss, they also might have positive effects on protecting against cardiovascular death, myocardial infarction, stroke, alcoholism, and cocaine abuse.
Let’s take those last two – alcohol and cocaine abuse. The findings on whether these drugs help with alcohol use disorder are a bit mixed so far, but researchers continue to look into the situation.
In one of the related studies, researchers in Denmark found that another class of drugs used to treat Type 2 diabetes – dipeptidyl peptidase 4 inhibitors (gliptins) – reduced the number of alcohol-related events for the people in their study.
Those “events” included being treated for alcoholism, buying medications to treat alcohol withdrawal syndrome, alcohol dependence, or visiting a hospital with an alcohol use disorder.
“It is likely that people will have to stay on these treatments for a while if they prove effective,” Christian Hendershot, who is leading a separate study on substance use disorders, said.
But there might be a downside
But he then threw this wrench into the works: “We do have some reason to believe that stopping GLP-1s could lead to a rebound effect in terms of drinking.”
Hendershot suggested that anyone who reads this and thinks they can Ozempic to suppress their alcohol intake might not find their physician ready to go along with the notion, because most healthcare professionals don’t have the proper training for addictions.
But he thinks all that will change as GLP-1 medications continue to grow in acceptance.
“These medications are becoming increasingly normalized, and very quickly. We know that many physicians will be comfortable prescribing them,” he said.
And cocaine?
Last summer, Yammine co-authored a small study regarding using exenatide – another diabetes drug – to roll down cocaine appetites. For six weeks, three people with the condition attended a weekly clinic visit and received exenatide injections and individual drug counseling.
“This is a very difficult population to keep engaged,” she noted. Out of her test group, two participants carried on with their use of cocaine through the study, but the third stopped by the second half. Yammine said the satisfaction scores were positive for the most part, and because of that, she wants to do a further, more involved study.
Your kidneys? Your brain?
Evidently, there’s not a body part that Ozemic, et al, can’t have some positive effect on. One thing we can keep our fingers crossed for is that it looks like these meds might protect the kidneys of people with diabetes and potentially slow down kidney disease.
Dr. Lance Alan Sloan, medical director of the Texas Institute for Kidney and Endocrine Disorders in Lufkin, recently wrote an article about the potential uses of GLP-1 receptor agonists. In it, he asserted that the next new FDA-approved indication of Ozempic and other GLP-1 drugs will be to safeguard against making matters worse for people with Type 2 diabetes who also experience chronic kidney disease.
In fact, Novo Nordisk – the company behind Ozempic – seems to be working in that direction already. In a press release in March, the company announced the results of an international trial that found patients receiving semaglutide were 24% less likely to experience progression of their kidney disease or kidney or cardiovascular death.
“Approximately 40% of people with type 2 diabetes have chronic kidney disease, so the positive results from [the study] demonstrate the potential for semaglutide to become the first GLP-1 treatment option for people living with type 2 diabetes and chronic kidney disease,” the company said.
Brain food?
The last body part that might be able to benefit from GLP-1 drugs? Our brains. Other trials have concluded that these drugs could reduce cognitive impairment and our risk of dementia.
Alireza Atri, an Alzheimer's disease clinician and researcher and director of the Banner Sun Health Research Institute in Arizona, told JAMA’s Rita Rubin that people who took GLP-1 were less likely to report cognitive impairment or dementia.
And, when researchers searched insurance databases to find a similar correlation, voila! Every single database showed a lower risk for cognitive impairment or dementia among people whose type 2 diabetes was treated with a GLP-1 receptor agonist, Atri said.
And, guess what, it’s another use of Ozempic not lost on Novo Nordisk either, so get ready. The company is conducting phase 3 trials using oral semaglutide to see if it can slow the progression of Alzheimer's disease in patients with brain amyloid deposits. Those results are expected in 2025.
Is there more? It's still early days for a lot of this research, but the results are definitely exciting. Who knew a diabetes medication could have this much potential?