Social networks are making new victims: type 2 diabetics. Indeed, to meet the often phantasmagorical demand for weight loss, many influencers (or rather influencers) recommend semaglutide. In an article published by The Conversation, Jean-Daniel Lalau recalls that in addition to its antidiabetic effect, this analog of GLP-1 (glucagon-like peptide 1) has the property of reducing weight.1.
This weight loss is dose-dependent: in a clinical trial, at one year, the doses of 0.05 mg, 0.1 mg, 0.2 mg, 0.3 mg and 0.4 mg respectively lead to weight loss. 6.0% (-6.7 kg), 8.6% (-9.3 kg), 11.6% (-12.3 kg), 11.2% (-12.5 kg) , and 13.8% (-15.1 kg).
At a weekly dose of 2.4 mg, the weight loss is on average 15% (15kg) once morest 2% (3kg) with the only change in lifestyle following 68 weeks of treatment.
Semaglutide is marketed under two names:
- Ozempic®in the form of pre-filled syringes, for weekly subcutaneous administration, available in 3 doses (0.25 mg, 0.5 mg, 1 mg) with a dosage to be increased gradually until reaching 1 mg per week and indicated in the treatment of type 2 diabetes;
- Wegs®, in syringes dosed at 2.4 mg, accessible as part of an early access procedure for very severe obesity (body mass index ≥40 kg/m2). This form is marketed in the United States, but not in France.
It is obviously much easier to obtain the first than the second, hence a misuse, particularly strong in Asia, with the aim of losing weight, very often even with a normal weight. This is where social networks and influencers play a crucial role, promoting the product outside of any medical reference.
In France, Health Insurance data show that of approximately 600,000 patients who received a GLP-1 analogue, including 125,000 Ozempic®, only 2,185 of them ” can be considered non-diabetic. The enthusiasm for the product would therefore be limited. Nevertheless, the National Agency for the Safety of Medicines and Health Products (ANSM) and Health Insurance have put in place enhanced surveillance for ” ensure that the prescriptions comply with the scope of use. »2
Indeed, misuse involves two types of risks. For the user, it is more gastrointestinal discomfort (nausea, vomiting, diarrhea) than serious adverse effects, although some have been reported (pancreatitis, for example). There is no blood sugar lowering effect unless the consumer is already taking insulin. On the other hand, the risk of weight gain, or even of a rebound effect, is real when administration of the product is stopped, especially if no change in lifestyle has taken place.
Above all, there is a major risk for type 2 diabetics, that of a supply disruption due to the intensity of misuse. For the moment it is contained and if there are difficulties in accessing semaglutide, they do not come from there, at least in France.
However, the author of the article is concerned regarding the meaning of this phenomenon with regard to the relationship to time: Immediately accessible communication disseminated via social networks on the effect of semaglutide on weight can run the risk of distracting from the slow and patient work, if not painful, to be carried out to modify one’s lifestyle, change one’s diet, increase one’s activity. physics, etc »
It concludes by giving several examples of the frequent difficulty in distinguishing between misuse and circumvention of the regulations: an off-label indication (marketing authorization) may be justified in certain cases, not investigated by clinical trials.