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What is semaglutide and how does it work?

Semaglutide is an injectable prescription medication used to improve blood sugar levels in adults with type 2 diabetes. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists.

Semaglutide works by mimicking the effects of GLP-1, a hormone that helps control blood sugar levels. It stimulates the release of insulin from pancreatic beta cells when blood sugar is high. It also decreases the amount of glucose released by the liver and slows digestion to help manage blood sugar levels.

Overall, semaglutide helps lower A1c (average blood sugar over 2-3 months) by improving the body's own ability to control high blood sugar.

What are the benefits of using semaglutide?

There are several key benefits of using semaglutide for type 2 diabetes:

• Significant A1c lowering – Clinical studies show semaglutide can lower A1c by up to 1.8% when used alone or with other diabetes medications. This can translate to improved long-term health.
• Weight loss – Semaglutide is proven to help people lose weight as well as control blood sugar. Weight loss averages 10-15 lbs over 68 weeks in clinical trials.
• Low risk of hypoglycemia – Semaglutide does not typically cause blood sugar to drop dangerously low when used alone. The risk increases when combined with medications like sulfonylureas.
• Convenient once-weekly dosing – Semaglutide is given as a simple subcutaneous injection just under the skin once per week. No need for daily injections.

By improving A1c, enhancing weight loss, and carrying a low risk of hypoglycemia, semaglutide offers robust benefits for managing type 2 diabetes over the long run.

What are the potential side effects of semaglutide?

Some of the more common side effects of semaglutide may include:

• Nausea and vomiting - About 20% of people report transient nausea. This generally improves over time.
• Diarrhea - Diarrhea occurs in up to 12% of individuals when starting semaglutide.
• Decreased appetite - Up to 6% report decreased appetite given semaglutide's weight loss effects.
• Abdominal pain
• Constipation
• Gas and bloating

These gastrointestinal effects tend to be mild or moderate and resolve within a few weeks of continued use. More serious side effects are possible but quite rare. Let your doctor know of any side effects you experience.

How much does semaglutide cost?

The retail cost of semaglutide can vary quite a bit based on individual insurance coverage:

• Cash/uninsured price - About $900-1,100 per Ozempic pen
• Medicare Part D - Copays average $35 to $250 per prescription
• Private insurance - Copays typically range from $15 to $150 per script

Manufacturer savings cards and patient assistance programs are also available to reduce out-of-pocket costs. Overall expenses can be high but the significant benefits may balance the costs for many people with uncontrolled type 2 diabetes.

Who should not use semaglutide?

There are a few key groups who should not use semaglutide:

• People with a personal/family history of thyroid C-cell tumors
• Those with severe kidney failure/dialysis dependence
• Women who are currently pregnant or breastfeeding
• People with a known allergy to semaglutide or any component of the medication
• Children or adolescents under 18 years old

It's also important to note that semaglutide has not been evaluated with insulin and should not be used along with an insulin pump.

Of course, any questions about the suitability of semaglutide should be discussed with the prescribing health care provider. Certain medical conditions or medications may impact who can safely use this medication as well. Monitoring with lab testing is recommended to detect any thyroid changes.