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Ozempic vs Tresiba
Introduction
For patients with Type 2 diabetes, certain medications that influence the body’s ability to regulate blood glucose levels can be instrumental in managing their condition. Ozempic and Tresiba are two such drugs that are commonly prescribed for this purpose. They each have different mechanisms of action but both contribute to better glycemic control in individuals with type 2 diabetes.
Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist which mimics the function of incretin hormones in the body, helping to stimulate insulin production when blood sugar levels rise too high. On top of that, it slows down gastric emptying and inhibits inappropriate secretion of glucagon - both activities resulting in lower blood glucose levels.
Tresiba (insulin degludec), on the other hand, is an ultra-long-acting basal insulin analog primarily used to manage fasting plasma glucose levels or background insulin needs throughout the day and night. It works by replacing or supplementing the insulin normally produced by pancreatic beta cells.
Ozempic vs Tresiba Side By Side
| Attribute | Ozempic | Tresiba |
|---|---|---|
| Brand Name | Ozempic | Tresiba |
| Contraindications | Diabetic ketoacidosis, allergic reactions to Ozempic, personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) | Diabetic ketoacidosis, allergic reactions to Tresiba |
| Cost | $800 to $850 for one pen (1.5 ml) | $600 to $700 for five FlexTouch pens (15 ml total) |
| Generic Name | Semaglutide | Insulin degludec |
| Most Serious Side Effect | Severe pain in your upper stomach spreading to your back, nausea and vomiting with a fast heartbeat, swelling or a lump in the neck with hoarseness, trouble swallowing or shortness of breath | Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat, symptoms of low potassium level, severe skin reactions |
| Severe Drug Interactions | Not specified, but caution advised when used alongside insulin due to increased risk of hypoglycemia | Not specified, but caution advised when used alongside other insulins or medications affecting glucose metabolism |
| Typical Dose | Starts at 0.25 mg once weekly, increasing to 0.5 mg after four weeks if needed, up to a maximum of 1 mg per week | Initial dosage based on the patient's current basal insulin usage, adjusted based on blood glucose targets, not administered more often than every eight hours |
What is Ozempic?
Semaglutide (the generic name for Ozempic) is a relatively new medication in the class of glucagon-like peptide-1 (GLP-1) receptor agonists used for managing type 2 diabetes. The FDA first approved it in 2017. Ozempic works by mimicking the functions of natural incretin hormones in your body that help keep your blood sugar stable—it increases insulin production, decreases excessive glucagon production, and slows digestion. This drug is prescribed to manage blood sugar levels in people with type 2 diabetes but it also has demonstrated potential benefits on weight loss and heart disease risks.
Insulin degludec (the generic name for Tresiba) belongs to a different class of medications called long-acting insulins, which was approved by the FDA in September 2015. Tresiba maintains constant glucose-lowering activity over time due to its multi-hexamer formation properties after injection under the skin; this gradually releases monomers that are absorbed into circulation at a slow and steady rate.
Comparing both drugs, while they have distinct mechanisms of action targeting glycemic control, Tresiba directly replaces deficient insulin secretion whereas Ozempic acts via GLP-1 pathway modulation additionally providing cardiovascular benefits and promoting weight loss.
What conditions is Ozempic approved to treat?
Ozempic has been approved for the treatment of type 2 diabetes as an adjunct to diet and exercise:
- Type 2 Diabetes Mellitus in adults, especially when metformin is not tolerated or contraindicated
- As a secondary therapy when oral hypoglycemic agents do not provide sufficient control
- It can also reduce risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes mellitus and established cardiovascular disease.
How does Ozempic help with these illnesses?
Ozempic assists in the management of type 2 diabetes by mimicking an intestinal hormone known as glucagon-like peptide-1 (GLP-1). This hormone is naturally responsible for stimulating insulin secretion when glucose levels rise, suppressing glucagon release to prevent excessive sugar production by the liver, and slowing gastric emptying. By replicating these effects, Ozempic can help maintain more stable blood glucose levels throughout the day.
Tresiba, on the other hand, is a long-acting basal insulin that helps control high blood sugar levels in people with diabetes. It works by substituting or supplementing the body's natural insulin which enables glucose to enter cells where it can be used for energy thus reducing overall blood sugar level.
Both medications aim to manage and regulate healthy blood sugar levels but they work through different mechanisms within the body. The choice between these two would depend on individual patient factors such as existing health conditions, lifestyle habits and personal preferences after discussing potential side effects with their healthcare provider.
What is Tresiba?
Tresiba is a brand name for insulin degludec, an ultra-long-acting basal insulin used to control high blood sugar in adults with diabetes mellitus. It works by mimicking the effects of natural insulin, meaning it helps glucose get into cells and thus prevents high levels of glucose building up in the bloodstream. Tresiba was first approved by the FDA in 2015.
Unlike Ozempic (semaglutide), which belongs to a class of drugs known as glucagon-like peptide-1 receptor agonists that stimulate insulin secretion and reduce glucagon production, Tresiba behaves like endogenous insulin; its action does not depend on stimulating other hormones or receptors. This fundamental difference means their side effect profiles differ: while both can cause low blood sugar (hypoglycaemia), weight gain is less likely with Ozempic than with Tresiba – however, nausea and abdominal pain are more common side effects of Ozempic.
Tresiba's long duration allows for flexibility in daily dosing time when needed which may be beneficial for patients who struggle with regular schedules. The ability to manage diabetes effectively requires individualized treatment plans; hence some individuals may respond better to one medication over another.
What conditions is Tresiba approved to treat?
Tresiba is an FDA-approved long-acting insulin used for the control of high blood sugar in people with:
- Type 1 diabetes, a condition where the body does not produce enough insulin
- Type 2 diabetes, a situation where either the body doesn't make enough insulin or can't use it effectively
How does Tresiba help with these illnesses?
Insulin degludec, known by the brand name Tresiba, is a long-acting insulin that works by mimicking the basal insulin release in your body. This hormone plays crucial roles in many processes within the body, affecting metabolism of carbohydrates and fats as well as promoting cell growth and division. As with glucose, low levels of insulin can lead to hyperglycemia or high blood sugar levels associated with diabetes. Tresiba works by providing a steady level of insulin over 24 hours, thereby controlling some symptoms of diabetes such as excessive thirst or urination. Its action on glucagon and amylin may also play roles in its effectiveness as an antidiabetic drug. Since it does not significantly affect postprandial (after meal) glucose control like short acting insulins do, it is often combined with them for patients requiring intensive glycemic control. It might be preferred when patients don't respond well to other long-acting insulins such as Ozempic or need a more predictable duration of action.
How effective are both Ozempic and Tresiba?
Both semaglutide (Ozempic) and insulin degludec (Tresiba) have proven records of success in managing type 2 diabetes. They were approved by the FDA a few years apart, with Tresiba being approved first. Both medications are used to lower blood sugar levels, but they work through distinct mechanisms: Ozempic as a glucagon-like peptide-1 receptor agonist that increases insulin secretion when glucose levels are high; and Tresiba as an ultra-long-acting basal insulin analog.
In clinical trials directly comparing these two medicines, both showed effective glycemic control over time. A double-blind trial conducted in 2018 indicated similar efficacy between the two treatments regarding HbA1c reduction[1]. However, patients on Ozempic had significantly greater weight loss compared to those on Tresiba - an important consideration given obesity's association with type 2 diabetes.
A meta-analysis from 2020 suggested that Ozempic could lead to significant reductions in cardiovascular events for people at risk[2], which is critically important since diabetics often experience heart problems due to their condition. On the other hand, Tresiba has shown its strength in providing long-lasting glycemic control with less risk of hypoglycemia -- even among those who miss doses occasionally.
To summarize, while both drugs have comparable efficacy in controlling blood sugar level overall, Ozempic might be more suitable for patients aiming for weight loss or having concerns about cardiovascular risks; whereas Tresiba may be better suited for those seeking stable blood sugar control without frequent dosage adjustments and less likelihood of experiencing low blood sugar episodes.
[1] https://www.nejm.org/doi/full/10.1056/NEJMoa1807842 [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054990/
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At what dose is Ozempic typically prescribed?
Dosages of Ozempic for managing type 2 diabetes typically start at 0.25 mg injected subcutaneously once weekly, with the dosage increasing to 0.5 mg after four weeks if needed. If blood glucose levels are not adequately controlled even then, the dose may be increased to a maximum of 1 mg per week. In contrast, Tresiba is also injected subcutaneously but its initial dosage varies depending on the individual's insulin requirements which can range from 10 units (U) to as high as required daily in adults and children aged one year or older with diabetes mellitus; this can be adjusted on an ongoing basis according to regular monitoring of blood sugar levels.
At what dose is Tresiba typically prescribed?
Tresiba treatment is typically initiated at a dosage that mirrors the patient's current basal insulin usage. The daily dose can then be adjusted based on individual blood glucose targets. Tresiba provides a steady release of insulin over 42 hours, which allows for flexible dosing times once daily. It's important to remember though that it should not be administered more often than every eight hours in any circumstance. If there is no response or inadequate control of blood glucose levels after several weeks of therapy, your healthcare provider may consider adjusting the dose further.
What are the most common side effects for Ozempic?
Besides helping to lower blood sugar levels, the medications Ozempic and Tresiba may also have some side effects. Some of the more common side effects with Ozempic include:
- Nausea
- Vomiting
- Stomach pain or discomfort
- Constipation
- Diarrhea
Whereas, Tresiba can cause:
- Hypoglycemia (low blood sugar)
- Allergic reactions such as rash, itching, or swelling at injection site
- Weight gain
With both medications, there's a risk of serious allergic reactions that require immediate medical attention. These are not exhaustive lists and individual responses may vary; always consult your healthcare provider for personalized advice.
Are there any potential serious side effects for Ozempic?
While Ozempic and Tresiba are both effective diabetes medications, they do have potential side effects. In some cases, Ozempic may cause:
- Severe pain in your upper stomach spreading to your back
- Nausea and vomiting along with a fast heartbeat
- Swelling or a lump in the neck accompanied by hoarseness, trouble swallowing or shortness of breath.
- Signs of an allergic reaction such as itching, rash, difficulty breathing or swelling of the face, lips or throat.
Tresiba on the other hand can occasionally result in:
- Low blood sugar symptoms including headache, dizziness, fast heart rate and hunger.
- High potassium levels leading to leg cramps and irregular heartbeats.
- Kidney problems - little or no urination; painful or difficult urination; swelling in your feet or ankles; feeling tired -or short of breath
If you experience any serious side effects from either medication consult your healthcare provider immediately.
What are the most common side effects for Tresiba?
Tresiba, a long-acting insulin used to control high blood sugar in diabetes patients, can result in certain side effects. These include:
- Injection site reactions, such as redness or swelling
- Weight gain
- Headache or dizziness
- Stomach pain and constipation
- Rash or itching at the injection site
- Fast heartbeat Additionally, Tresiba may cause low potassium levels in the blood (hypokalemia), which may lead to muscle cramps or weakness. It's important to note that these side effects are generally mild and manageable but should be reported if they persist or worsen.
Are there any potential serious side effects for Tresiba?
While Tresiba is generally well-tolerated, it's important to keep in mind that certain side effects can still occur. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Symptoms of low potassium level including leg cramps, constipation, irregular heartbeats or fluttering in your chest
- Signs of a severe skin reaction like fever and sore throat followed by a red or purple skin rash that spreads (especially in the face or upper body) causing blistering and peeling
- Sudden vision changes or loss accompanied by eye pain and redness
- Swelling around your ankles or feet indicating possible kidney issues
- Rapid weight gain which might be due to fluid retention typically characterized with shortness of breath during exertion.
If you experience any unusual symptoms while taking Tresiba, make sure to contact your healthcare provider for advice.
Contraindications for Ozempic and Tresiba?
Both Ozempic and Tresiba are injectable medications used in the management of diabetes. However, like all drugs, they may exacerbate certain symptoms or conditions. If you notice any severe side effects such as trouble breathing, rapid heartbeat, or persistent nausea/vomiting after taking these medications, seek immediate medical attention.
Neither Ozempic nor Tresiba should be taken if you have been diagnosed with diabetic ketoacidosis or if you experience an allergic reaction to them. Always inform your physician about other medications you are currently taking; this is crucial for avoiding potential interactions between drugs.
It's important to know that both Ozempic and Tresiba don't work well when taken alongside insulin. They shouldn’t be used together unless specifically directed by your healthcare provider due to the increased risk of hypoglycemia (low blood sugar).
Also note that thyroid tumors (including cancer) have been observed in some patients using Ozempic so it's not recommended for those with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
How much do Ozempic and Tresiba cost?
For the brand-name versions of these drugs:
- The price of one pen (1.5 ml) of Ozempic (semaglutide) averages around $800 to $850, which works out to approximately $26-$28 per day based on a weekly dosage.
- The price of five FlexTouch pens (15 ml total) Tresiba (insulin degludec), ranges from about $600 to $700, working out roughly between $4 and 4.60/day.
Thus if you are using the higher dosage range for Tresiba, then it will be less expensive on a per-day treatment basis compared with Ozempic. Please note that cost should not be your primary consideration in determining which medication is right for you.
As far as we know, there are no generic versions available for either Ozempic or Tresiba yet; therefore their costs remain high compared with other types of insulin therapy.
Popularity of Ozempic and Tresiba
Semaglutide, in its injectable form known as Ozempic, was prescribed to an estimated 1.5 million people in the US in 2020. Semaglutide accounted for approximately 7% of GLP-1 receptor agonist prescriptions in the US. This class of drugs is often used when metformin and lifestyle changes are not enough to control blood glucose levels in type 2 diabetes patients. The use of semaglutide has been steadily increasing since it was approved by the FDA for use in adults with type 2 diabetes in late 2017.
Insulin degludec, also known by its brand name Tresiba, was prescribed to just under a million people in the USA during that same period. In terms of long-acting insulin prescriptions, insulin degludec accounts for around 10%, and its prevalence has seen a steady increase over recent years due to its prolonged duration of action which allows more flexibility than other insulins regarding when doses can be taken.
Conclusion
Both Ozempic (semaglutide) and Tresiba (insulin degludec) are widely recognized options for managing diabetes, with numerous clinical studies and meta-analyses supporting their efficacy over placebo treatments. Although both drugs aim to control blood sugar levels, they function differently. Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that increases insulin secretion and suppresses inappropriate glucagon secretion, while Tresiba is a long-acting basal insulin intended to provide consistent glucose-lowering effect.
Ozempic may also be used as an adjunctive therapy to other antidiabetic medications or in patients who need additional glycemic control along with the benefit of weight loss. On the other hand, Tresiba provides continuous 24-hour action for day-to-day use which can be particularly beneficial for individuals having difficulty maintaining stable blood glucose levels throughout the day.
Both drugs are available only in brand form at present, potentially making them more expensive especially for those paying out-of-pocket. Both Ozempic and Tresiba may require an adjustment period where doses are titrated based on individual patient response.
The side effect profiles differ somewhat between these two medications; common side effects of Ozempic include nausea and vomiting whereas low blood sugar (hypoglycemia) is more commonly associated with Tresiba use. In any case, it's critical that patients monitor their blood sugar regularly during treatment initiation or dose adjustments and seek medical help immediately if they experience symptoms indicative of high or low blood sugars.
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Refrences
- Aroda, V. R., Ahmann, A., Cariou, B., Chow, F., Davies, M. J., Jódar, E., … Lingvay, I. (2019, October). Comparative efficacy, safety, and cardiovascular outcomes with once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes: Insights from the SUSTAIN 1–7 trials. Diabetes & Metabolism. Elsevier BV.http://doi.org/10.1016/j.diabet.2018.12.001
- Wysham, C., Bhargava, A., Chaykin, L., de la Rosa, R., Handelsman, Y., Troelsen, L. N., … Norwood, P. (2017, July 4). Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes. Jama. American Medical Association (AMA).http://doi.org/10.1001/jama.2017.7117
- Wakil, A., & Atkin, S. L. (2012, February 15). Efficacy and safety of ultra-long-acting insulin degludec. Therapeutic Advances in Endocrinology and Metabolism. SAGE Publications.http://doi.org/10.1177/2042018812437181
- Dhillon, S. (2018, January 23). Semaglutide: First Global Approval. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-018-0871-0