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Can you take Ozempic for prediabetes?

Prediabetes is an off-label use of Ozempic
Gerardo Sison medical writer headshot
By | Oct. 3, 2024
An Ozempic pen: Can you take Ozempic for prediabetes?

Key takeaways

  • Ozempic is FDA-approved for Type 2 diabetes but may be prescribed off-label for prediabetes and weight loss.

  • Prediabetes is when blood sugar levels are higher than normal but not yet Type 2 diabetes.

  • Ozempic may help with blood sugar control in prediabetes, but insurance usually doesn’t cover it for off-label use.

In this article:

If you have been experiencing high blood sugar levels or have recently been diagnosed with prediabetes, you might be exploring different treatment options. A healthcare provider may even suggest Ozempic (semaglutide), a medication approved by the Food and Drug Administration (FDA) to treat Type 2 diabetes. It is also approved to reduce the risk of serious heart problems in adults with Type 2 diabetes who have heart disease or are at high risk for heart issues.

Given its recent popularity for weight loss, many people may be curious about whether Ozempic can also help with prediabetes. But weight loss and prediabetes are both off-label uses of the drug, meaning they’re not FDA-approved uses. Still, there are situations when a healthcare provider could prescribe Ozempic for prediabetes.

What is prediabetes?

Prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be classified as Type 2 diabetes. When a person has prediabetes, their body starts to become insulin resistant, meaning it doesn’t use insulin effectively. Insulin resistance can lead to higher blood glucose levels over time.

Risk factors and consequences of prediabetes

Common risk factors for prediabetes include being overweight, having a family history of diabetes, leading a sedentary lifestyle, and being over 45 years old. Symptoms may not always be obvious, but some people experience increased thirst, frequent urination, and fatigue.

Doctors diagnose prediabetes through blood tests. Key indicators are:

  • Fasting blood sugar level: 100–125 mg/dL
  • A1C level: 5.7%–6.4%
  • Oral glucose tolerance test: 140–199 mg/dL two hours after consuming a sugary drink

If left untreated, prediabetes can progress to Type 2 diabetes, increasing the risk of severe complications like heart disease and stroke. Individuals may also experience nerve damage, leading to pain or loss of sensation, and kidney issues that could result in kidney failure. In addition, untreated diabetes may cause vision problems, including diabetic retinopathy, potentially leading to blindness.

Ozempic as a treatment for prediabetes

Ozempic is administered as a weekly injection and acts as a GLP-1 agonist, which mimics the glucagon-like peptide-1 hormone. It regulates blood sugar levels and increases insulin production when necessary, and it shows promise in treating prediabetes.

One study evaluated the effects of semaglutide on adults with obesity or overweight across three clinical trials involving 3,375 participants over 68 weeks. The results showed that almost 90% of people with prediabetes who took semaglutide achieved normal blood sugar levels, compared to only 70% of those who received a placebo. 

In some cases, Ozempic may be prescribed off-label for weight loss and obesity management. However, the active ingredient in Ozempic, semaglutide, is available under the brand name Wegovy, which is specifically approved for weight loss.

How to use Ozempic for prediabetes

There is no specific dosage for using Ozempic to treat prediabetes. But for Type 2 diabetes, the approved starting dose is 0.25 milligrams (mg) weekly. After four weeks, the dose may be increased to 0.5 mg. If blood sugar levels need to be better controlled, a healthcare provider may recommend gradually increasing the dose in four-week intervals until a dosage of 2 mg weekly is reached. 

Ozempic is given through a pen injected under the skin. Common injection sites include the stomach area, thigh, and upper arm. Injection sites should be rotated to avoid using the same spot each time.

Other key factors of using Ozempic:

  • Storage: Each Ozempic pen has four doses, and you’ll use the same pen to inject Ozempic once a week throughout the month. It should be kept in the refrigerator until ready to use. Once you’ve used the pen for your first dose, you can keep it at room temperature for up to 56 days.
  • Lifestyle changes: Ozempic is meant to be used alongside lifestyle changes like diet and exercise for maximum effectiveness.
  • Missed doses:  If a dose is missed, a dose should be given within five days of the missed dose. If more than five days have passed, the missed dose should be skipped, and another dose should be given on the regular schedule.

Always consult a healthcare provider before starting Ozempic, especially if it’s being used off-label. They will provide the appropriate dosage and monitor your progress.

Ozempic side effects and warnings

When taking Ozempic for prediabetes, it’s important to be aware of potential side effects and warnings. Common side effects may include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Constipation
  • Headaches
  • Fatigue

These side effects may go away as the body adjusts to the medication.

Serious side effects of Ozempic

Ozempic comes with several important warnings. It may increase the risk of thyroid tumors, particularly medullary thyroid carcinoma (MTC), especially in people with a family history of thyroid problems. 

Pancreatitis, or inflammation of the pancreas, is also a concern. Symptoms of pancreatitis may include severe abdominal pain, nausea, and vomiting.

In addition, Ozempic can worsen diabetic retinopathy, making regular eye check-ups essential. When used with insulin or certain diabetes medications, Ozempic may cause low blood sugar, so monitoring blood sugar levels is important. There are also risks of kidney problems and allergic reactions.

RELATED: Ozempic eye side effects

Who should not take Ozempic for prediabetes?

Certain individuals should avoid using Ozempic due to potential risks and health complications. Here are some key groups who should not take Ozempic:

  • People with a personal or family history of thyroid cancer
  • People with multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • Anyone who has had a serious allergic reaction to semaglutide or any ingredient in Ozempic

Symptoms of a serious allergic reaction may include:

  • Swelling of the face, lips, tongue, or throat
  • Problems with breathing or swallowing
  • Severe rash or itching
  • Fainting or feeling dizzy
  • Very rapid heartbeat

People with certain health conditions should use extra caution when considering Ozempic:

  • Those with a history of pancreas or kidney problems
  • Individuals with diabetic retinopathy
  • Women who are pregnant or planning to become pregnant—they should stop using Ozempic for two months before planning to get pregnant
  • Women who are breastfeeding or planning to breastfeed

Always consult a healthcare provider about all your medications, including prescription and over-the-counter drugs, vitamins, and herbal supplements. Ozempic may interact with other medications.

Lifestyle changes to manage prediabetes

Instead of prescribing medication, healthcare providers typically suggest lifestyle changes first in people with prediabetes. These adjustments may help lower blood sugar levels and reduce the risk of progressing to Type 2 diabetes.

Diet

Dietary changes involve eating a balanced diet rich in whole foods. Choose vegetables, fruits, whole grains, and lean proteins. Reducing sugary foods and refined carbohydrates may also help manage blood sugar levels.

Exercise

Regular exercise is important. Aim for at least 30 minutes of moderate activity most days of the week. This could include walking, biking, or swimming, for example. Activity helps the body use insulin more effectively.

Weight loss

Weight loss may make a big difference. Losing even a small amount of weight may help lower blood sugar levels and improve insulin sensitivity. Focus on gradual, sustainable weight loss to keep these benefits long-term.

Stress management

Managing stress may also be a helpful part of managing prediabetes. High stress levels can negatively affect blood sugar control. Stress management techniques like meditation, yoga, and deep breathing may help reduce stress.

Adequate sleep

Sleep quality should not be overlooked. Poor sleep can affect blood sugar levels and overall health. To support the body’s functions, aim for seven to nine hours of quality sleep each night.

Making these lifestyle changes may help manage blood sugar levels and improve overall health.

Comparing Ozempic with other treatments

Ozempic is a potentially effective option for managing blood sugar levels in individuals with prediabetes. Yet, it is not the only option available. Several other medications may be considered for managing prediabetes. However, prediabetes may be an off-label use for many of these medications:

  • Metformin: This medication is often the first-line treatment for Type 2 diabetes and may be considered for prediabetes management. It works by decreasing liver glucose production and improving insulin sensitivity. Metformin is generally well-tolerated and has a favorable safety profile, making it a common choice among healthcare providers.

RELATED: Ozempic vs. metformin

  • SGLT2 inhibitors: These prescription drugs help lower blood sugar by causing the kidneys to remove sugar through the urine, effectively reducing overall glucose levels in the body. Examples include Jardiance (empagliflozin) and Invokana (canagliflozin), both of which have been shown to provide cardiovascular benefits as well. In addition to managing blood sugar, these medications may also support weight loss.
  • Thiazolidinediones: This class of drugs may help improve insulin sensitivity in the body, making it easier for cells to use glucose effectively. Actos (pioglitazone), for example, can be particularly beneficial for people with insulin resistance. 
  • Dipeptidyl peptidase 4 (DPP-4) inhibitors: These medications help increase insulin production in response to meals, helping to manage blood sugar levels after eating. Examples include Januvia (sitagliptin) and Tradjenta (linagliptin). Additionally, DPP-4 inhibitors may have a neutral effect on weight, making them a potential option for many people with prediabetes.
  • Other GLP-1 agonists: Similar to Ozempic, these medications help lower blood sugar levels by improving insulin secretion and slowing stomach emptying. Examples include Trulicity (dulaglutide) and Victoza (liraglutide). They may also support weight loss, which can be beneficial for people with prediabetes and obesity or overweight.

Consult a healthcare provider to determine the best plan of action for managing blood sugar levels. They can provide medical advice based on specific health needs and preferences.

How much does Ozempic cost?

The average retail price of Ozempic is $1,327 per 3 mL pen, which is a one-month supply. That’s the cost of Ozempic without discounts or insurance, though. Furthermore, Ozempic prices vary by pharmacy and location.

If cost is a concern when using Ozempic, it may be helpful to compare prices at different pharmacies. In some cases, a healthcare provider may recommend a cheaper alternative, such as a medication from a different drug class or that’s available as a generic.

There are various ways to save on Ozempic, with or without insurance. One easy and instant savings option is by using your SingleCare card. With a free SingleCare prescription discount card, you can compare Ozempic prices from local pharmacies to see where it’s most affordable. With an Ozempic coupon from SingleCare, you could pay $754 instead of $1,327.  

Will insurance cover Ozempic for prediabetes?

Ozempic is not typically covered when prescribed for off-label uses like prediabetes. Most health insurance plans tend to cover Ozempic primarily for Type 2 diabetes treatment.

Medicare coverage for Ozempic is limited for prediabetes. Other insurance providers might also have restrictions on covering this medication for prediabetes treatment.  Each plan is different, so it’s important to check with the insurance provider to understand what is covered.

Bottom line

Ozempic is a medication mainly for Type 2 diabetes but can be prescribed off-label for prediabetes to help lower blood sugar and support weight loss. It’s not officially approved for prediabetes and may have side effects like nausea and inflammation of the pancreas. 

Healthcare providers usually recommend lifestyle changes like diet and exercise first. In addition, insurance coverage may be limited for using Ozempic for prediabetes, so it’s important to check with your healthcare provider and insurance plan.