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Can people with type 1 diabetes take Ozempic?

GLP Guidebook teamUpdated 5 Oct 202615 sourcesWritten from published sources
The short answer

No, not as an approved use. India approved Ozempic (semaglutide) in September 2025 for type 2 diabetes only, and the US and EU labels cover type 2 too. The EU label says it is not a substitute for insulin. When insulin users start a GLP-1 medicine and cut insulin fast, diabetic ketoacidosis (DKA), an emergency, has been reported.

Before you go further
  • GLP‑1 medicines are prescription-only in India, not sold over the counter.13
  • A government statement on 1 Apr 2026 said only endocrinologists, internal-medicine specialists and cardiologists can prescribe them.13 CDSCO expert-committee minutes attach a similar condition to some approvals (endocrinologist or internal-medicine specialist), but we found no rule covering every brand.14,15
  • The risks are in Guide 5: Side effects and risks.
  • Nothing here promises any result.

What is the difference between type 1 and type 2 diabetes?

In type 1 diabetes, the immune system destroys the pancreas's insulin-making cells, so people need insulin from diagnosis and for life.4,5

Type 2 diabetes is over 90% of all diabetes. The body still makes insulin but responds poorly to it (insulin resistance) and releases it abnormally.4 In India, ICMR cites about 5 new cases a year per 100,000 children and young people. Cases peak at ages 10 to 14.5

Ozempic lowers blood sugar partly by making the pancreas release more insulin when sugar is high.2 In type 1, those cells are gone.4 If you have type 2 diabetes, our type 2 diabetes path covers where these medicines fit.

What do Ozempic's labels say about type 1 diabetes?

India approved Ozempic in September 2025 for adults with type 2 diabetes, and every use on the US label is for type 2 too.1,2

The EU label says semaglutide "is not a substitute for insulin" and should not be used to treat DKA.3 DKA is high blood sugar plus a build-up of acids (ketones), caused by too little insulin.5 It reports DKA when insulin users cut insulin fast on starting a GLP‑1 medicine.3 With insulin, Ozempic also raises the risk of low blood sugar (a hypo), including severe hypos (US label).2

Get help now: call 112 if someone on insulin has vomiting, stomach pain or unusual drowsiness. Also call for fast, laboured breathing with a fruity smell. These can be signs of DKA.3,5 Nausea, vomiting and stomach pain are also common Ozempic side effects, so the two are easy to mix up.2
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What have trials of GLP-1 medicines in type 1 diabetes found?

HbA1c fell a little, but weight fell 5 to 9 kg more than on a dummy, and the biggest trial we found had more hypos.6,8

ADJUNCT ONE tested liraglutide, an older GLP‑1 medicine. It added up to 1.8 mg or a dummy injection to insulin in 1,398 adults for 52 weeks.6 At 1.8 mg, HbA1c fell 0.2 points more than on the dummy, and weight 5 kg more.6 Hypos with symptoms rose to about 17 a year per person, against 12. High sugar with ketones hit 11% of people, against 7%.6,7

In 2025, ADJUST-T1D gave weekly semaglutide (up to 1 mg, Ozempic's top Indian strength) or a dummy for 26 weeks.1,8 Its 72 adults had a BMI of 30 or more and automated insulin pumps.8 HbA1c fell 0.3 points more and weight about 9 kg more on semaglutide. Each group had 2 severe hypos, and no one had DKA.8

Is anything changing for type 1 diabetes?

Not yet. Semaglutide isn't approved to treat blood sugar in type 1, and a large tirzepatide (Mounjaro) trial in type 1 is still running.10,12

That trial, Lilly's SURPASS-T1D-1, in about 905 adults with overweight or obesity, is due to finish in December 2026.10 A 12-week trial of 24 adults found about 9 kg more weight loss on tirzepatide than on a dummy.9 A 2026 review rated the tirzepatide evidence in type 1 as low or very low certainty.11

Some doctors still prescribe semaglutide off-label, meaning outside its approved uses. In Denmark, 879 people with type 1 diabetes started it between 2018 and 2024.12 Against similar non-users, hospital stays for hypos or DKA did not clearly rise. But the study was observational, and the DKA estimate ranged from far fewer stays to 1.6 times as many. Half had stopped within a year.12

RisksThe risks, in brief
  • DKA has been reported when insulin was stopped or cut quickly after starting a GLP‑1 medicine (EU label).3
  • Hypos, including severe ones, are more likely when Ozempic is used with insulin (US label).2
  • Stomach effects are common: nausea, vomiting, diarrhoea, stomach pain and constipation.2
  • Pancreatitis (a swollen pancreas) and gallbladder disease have been seen on Ozempic.2
  • Thyroid warning. Ruled out by the US label for anyone with a personal or family history of medullary thyroid cancer or MEN 2; tell your doctor if this applies.2
  • Pregnancy. The US label says stop at least 2 months before a planned pregnancy.2
Full detail in Guide 5: Side effects and risks →

Read the full picture

Related questions

Can you take Ozempic if you don't have diabetes? Is Ozempic available in India? When should you call 112 on a GLP-1 medicine? Can you take metformin and Ozempic together? What is a normal HbA1c?
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Sources

  1. Neetu Chandra Sharma. Ozempic gets India nod: drug regulator approves Novo Nordisk's blockbuster diabetes drug. Business Today, updated 26 Sep 2025. businesstoday.in
  2. Novo Nordisk. Ozempic (semaglutide) US prescribing information, revised 05/2026. US label, not the Indian one: we found no public Indian label. Boxed warning, sections 1, 5.2, 5.5, 5.9, 6.1, 8.3, 12.1. novo-pi.com
  3. European Medicines Agency. Ozempic (semaglutide): EU summary of product characteristics and package leaflet. EU label, not the Indian one. Sections 4.2 and 4.4; leaflet section 2. Checked 5 Oct 2026. ema.europa.eu (PDF)
  4. Indian Council of Medical Research. ICMR Guidelines for Management of Type 2 Diabetes 2018. Section 1.3, p. 2. icmr.gov.in (PDF)
  5. Indian Council of Medical Research. Guidelines for Management of Type 1 Diabetes, 2022. Chapter 1 (p. 1), chapter 3 (p. 22), chapter 5 section A (pp. 66–68). icmr.gov.in (PDF)
  6. Mathieu C et al. Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes: the ADJUNCT ONE treat-to-target randomized trial. Diabetes Care 2016;39(10):1702-10. Sponsored by Novo Nordisk (NCT01836523). doi:10.2337/dc16-0691 · PMID 27506222
  7. Seetharaman S, Cengiz E. The promise of adjunct medications in improving type 1 diabetes outcomes: glucagon-like peptide receptor agonists. J Diabetes Sci Technol 2025;19(2):311-320. Review; source of the ADJUNCT ONE event rates. doi:10.1177/19322968241309896 · PMID 40022528
  8. Shah VN et al. Semaglutide in adults with type 1 diabetes and obesity (ADJUST-T1D). NEJM Evidence 2025;4(8):EVIDoa2500173. Funded by Breakthrough T1D. doi:10.1056/EVIDoa2500173 · PMID 40550013
  9. Snaith JR et al. Tirzepatide in adults with type 1 diabetes: a phase 2 randomized placebo-controlled clinical trial. Diabetes Care 2026;49(1):161-170. doi:10.2337/dc25-2379 · PMID 41264593
  10. ClinicalTrials.gov. A study of tirzepatide (LY3298176) compared with placebo in adults with type 1 diabetes and obesity or overweight (SURPASS-T1D-1, NCT06914895), Eli Lilly. Active, not recruiting; estimated enrolment 905; estimated completion Dec 2026 (record updated 12 May 2026). clinicaltrials.gov
  11. Acucella GA, Caponio D. Tirzepatide as adjunct to insulin in adults with type 1 diabetes and overweight or obesity: a systematic review of randomized and real-world evidence. Endocrinol Diabetes Metab 2026;9(3):e70225. doi:10.1002/edm2.70225 · PMID 42007544
  12. Würtz Yazdanfard PD et al. Effectiveness and safety of semaglutide in type 1 diabetes: a Danish nationwide cohort study (2018–2024). Lancet Reg Health Eur 2026;66:101716. Observational. doi:10.1016/j.lanepe.2026.101716 · PMID 42205711
  13. Outlook India. Inspections, surveillance to continue against unauthorised sale, promotion of GLP-1 weight-loss drugs: govt, 1 Apr 2026. outlookindia.com
  14. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology and Metabolism), meeting of 20–21 Apr 2023, item 1 (tirzepatide). Committee minutes, not the final permission. PDF · archived copy
  15. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology and Metabolism), meeting of 13–14 Feb 2024, items 3–4 (semaglutide). Committee minutes for two named products. PDF · archived copy

Last checked 5 Oct 2026 · Next review due 5 Apr 2027 · Report an error

How this answer was made. Written by the GLP Guidebook team from the sources above. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any medicine. How we write