Insulin resistance is a condition where the body cells don't respond effectively to insulin — a hormone that regulates blood sugar levels. This can lead to high blood sugar, which indicates type 2 diabetes. While lifestyle changes like a healthy diet and regular exercise play a crucial role in managing insulin resistance, some medications can also contribute to improving insulin sensitivity, one of which is Wegovy.

Wegovy helps individuals with insulin resistance by reducing appetite, inducing satiety, enhancing weight loss, and ultimately improving insulin sensitivity and blood sugar management.

Key Facts

  • Insulin resistance is not only linked to type 2 diabetes but also obesity, and Wegovy is not only effective for weight loss but also blood sugar control.
  • Wegovy shares the same active ingredient with Ozempic and Rybelsus: Semaglutide.
  • While Wegovy is categorized under weight loss drugs, Ozempic and Rybelsus are approved for type 2 diabetes management.
  • Wegovy is specifically approved for adults with obesity (BMI ≥30) or overweight (BMI ≥27) who also have weight-related comorbidities like Cardiovascular disease. However, there is a link between obesity and insulin resistance, and Wegovy improves insulin sensitivity while promoting weight loss.

Understanding Insulin Resistance

Insulin is a hormone manufactured by the pancreas to enable our body to use the sugar from the carbohydrates we eat for energy. It also signals the liver to store blood sugar for future use.

In individuals with insulin resistance, their cells don't respond appropriately to insulin, causing the pancreas to produce more insulin to maintain normal blood sugar levels. This can contribute to weight gain.

Over time, the cells can become too resistant to insulin, and the pancreas can get overworked. This can lead to high blood sugar levels, which can eventually result in type 2 diabetes.

"One of the things we've always been taught is that controlling diabetes is about controlling blood glucose," says Dr. Jason Fung. "The real issue, though, is that high blood glucose is only a symptom of the disease and not the actual disease. The actual disease of type 2 diabetes is one of high insulin resistance, and that's what causes the high blood glucose," he added.

It's important to note that insulin resistance is not only linked to type 2 diabetes but also to various other health conditions, including obesity, metabolism disease, non-alcoholic fatty liver disease, polycystic ovary syndrome (PCOS), and cardiovascular disease.

The Science Behind Wegovy for Insulin Resistance

Wegovy is one of the few weight loss medications approved by the U.S. Food and Drug Administration (FDA). However, it can also be beneficial for individuals with insulin resistance and prediabetes. The active ingredient in Wegovy is Semaglutide, which belongs to a class of medications known as glucagon-like peptide-1 receptor agonists, or GLP-1 RAs.

Here is a breakdown of how Wegovy works for insulin resistance:

  • Appetite Control: Wegovy mimics a natural gut hormone called glucagon-like peptide-1 (GLP-1). It works on the brain to reduce appetite and increase the feeling of fullness, which can help with weight loss. Maintaining a healthy weight is essential for improving insulin sensitivity and reducing insulin resistance.
"A GLP-1 agonist (like Wegovy) is a medication that triggers an excessive and prolonged release of the GLP-1 (hormone) when you're eating," says Dr. Robert Cywes. "The first thing it does is increase the taste sensation in your mouth and give you early satiety in your stomach as well as your head (brain). So, it's essentially a satiety medication that gives you early and prolonged satiety, meaning you eat less and less often," he added.
  • Blood Sugar Regulation: Wegovy also helps regulate blood sugar levels by increasing insulin sensitivity. It reduces the amount of sugar released by the liver and slows down stomach emptying and the absorption of sugar from the digestive tract, which can lead to better blood sugar control.
"At a hormonal level, GLP-1 agonists (Wegovy) trigger insulin release. When sugar gets into your bloodstream, there is a small amount of insulin released, but the bigger release of insulin is related to GLP-1. The other thing that GLP-1 does is it blocks glucagon; it blocks the production and release of sugar by the liver. So, you get a reduction in inherent sugar production and release. And you get an increase in insulin, which helps you clear the sugar remnants in the bloodstream," says Dr. Cywes. "By decreasing the gradient between your bloodstream sugar and intracellular sugar, the cell automatically recruits insulin receptors because it needs sugar to come into the cell, and that is how you break insulin resistance," he emphasized.
  • Weight Loss: Obesity is often associated with insulin resistance. Wegovy can help individuals lose weight, which in turn can improve insulin sensitivity. Studies have shown significant weight loss in patients using Wegovy.

Benefits of Wegovy for Insulin Resistance

One of the key benefits of Wegovy is its ability to enhance insulin sensitivity. Insulin resistance is characterized by cells not effectively responding to insulin. Wegovy helps improve this response, making it easier for the body to regulate blood sugar levels.

Obesity is closely linked to insulin resistance. Another primary benefit of Wegovy is that it promotes weight loss by reducing appetite and increasing the feeling of fullness. Shedding excess weight can contribute to improving insulin sensitivity. Moreover, the medicine's appetite-controlling properties can make it easier for individuals to adhere to a healthier diet, which is critical in managing insulin resistance.

By addressing the root causes of insulin resistance, Wegovy can lower the risk of prediabetes progressing to Type 2 diabetes. This is crucial for long-term health and reducing the need for diabetes management.

Most importantly, Wegovy's capacity to improve insulin sensitivity and lower blood sugar can positively affect overall health. Individuals may experience increased energy levels, reduced fatigue, and a decreased risk of diabetes-related complications.

"When I started Wegovy last April, I felt bloated, lightheaded, irritable, and I still felt hungry. I have now lost 40 pounds. My blood pressure is down. My back hardly hurts anymore. I can pick up my two grandkids at the same time. I can also bend over and tie my shoes...something I couldn't do for 10 years. I exercise more (but not crazily so), and I watch what I eat. In short, I feel a whole lot better about myself than I used to," says a patient on Wegovy.

Potential Side Effects and Considerations

Despite the numerous benefits of Wegovy for insulin resistance, like all medications, it can have potential side effects, depending on your age, health history, other health conditions, or other medicines you take. Using Wegovy under the guidance of a healthcare provider who can weigh the potential benefits against the risks and monitor your progress is crucial.

Let's explore some potential side effects and considerations associated with Wegovy.

Minor Side Effects of Wegovy:

  • Nausea
  • Bloating or abdominal pain
  • Gas
  • Stomach flu
  • Vomiting
  • Constipation
  • Indigestion, heartburn, or gastroesophageal reflux disease (GERD)
  • Burping
  • Diarrhea
  • Dizziness
  • Headache

These minor side effects are common and usually go away after a few weeks of beginning the treatment. However, you can talk to your healthcare provider if they become persistent and bothersome.

Severe Side Effects of Wegovy

Although rare, more severe complications that may arise from taking Wegovy include,

  • Boxed warning of thyroid tumors (potentially including cancer).
  • Pancreatitis (inflammation and swelling of the pancreas). Signs include persistent severe abdominal pain, sometimes radiating to the back, which may or may not be accompanied by vomiting.
  • Gallbladder problems. Signs include a persistent, gripping pain in the upper right abdomen near the rib cage, often severe and may extend to the upper back. Other symptoms of a gallbladder issue include fever, chills, nausea, vomiting, gas, abdominal discomfort after meals, chronic diarrhea, yellowing of the skin or eyes (jaundice), or clay-colored stools.
  • Changes in vision - Often associated with a temporary worsening of diabetic retinopathy due to a rapid improvement in glucose control.
  • Kidney disease. This may make you urinate more or less often than is typical. You may also experience nausea and fatigue.
  • Severe allergic reaction. Signs include any of the following: Facial, lips, mouth, tongue, or throat swelling; trouble with breathing, swallowing, or talking; severe rash, hives, or itching; rapid heartbeat; wheezing or feeling of chest tightness; fainting or feeling dizzy; blistered or peeling skin (with or without fever).

You have to look out for these severe side effects and report them to your doctor promptly.

Top Considerations Before Taking Wegovy

Muscle Loss

While GLP-1 agonists like Wegovy can trigger weight loss, which improves insulin sensitivity, losing weight rapidly can also reduce your muscle mass, weaken your bones, and lower your resting metabolic rate, which can cause sarcopenia, especially if you are an older adult or have poor eating habits and lifestyle.

"Because people continue eating poor diets deficient in protein, fatty acids, vitamins, and minerals (while on Wegovy), there is an inordinate amount of muscle loss that goes along with the weight loss," says Ken D. Berry, MD. "Keep in mind, if you are overweight, you don't want to lose muscle; you just want to lose the fat. But if you are eating a high-carb, low-protein, low-fat diet, and you are eating much less food than you ate previously (due to the Wegovy effect), you may lose some muscles," he added.

Talk to your doctor if you have concerns about muscle loss while on Wegovy. They may recommend basic lifestyle changes like eating healthier, balanced diets and exercising your muscles often.

Nausea

Nausea is a common side effect of Wegovy but often improves with continued treatment.

Severe nausea may result from overdosing on Wegovy, but it's not an expected side effect at recommended dosages. However, if, in any case, your nausea becomes bothersome, you can book an appointment with your doctor.

Constipation

Constipation is a possible side effect of Wegovy, though it's usually not severe enough to cause discontinuation.

In most cases, constipation linked to Wegovy may resolve as treatment continues. But if it becomes persistent or bothersome, you can reach out to your doctor.

Risk of Thyroid Cancer

In recent experiments, Wegovy, which contains Semaglutide, increased the risk of cancerous tumors in animals. Whether this risk applies to humans is yet to be established. Symptoms of a thyroid tumor may include difficulty swallowing, hoarseness, neck lump or swelling, and shortness of breath.

Doctors are cautious about prescribing Wegovy to individuals with a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer) and those with multiple endocrine neoplasia syndrome type 2, a genetic disorder linked to thyroid cancer.

If symptoms of a thyroid tumor appear while using Wegovy, contact your doctor for examination and possible lab tests to assess safety.

Consultation with Healthcare Professionals

While Wegovy is approved for weight loss, it's noteworthy that the medication must be taken as prescribed by your doctor and combined with exercise and a healthy diet for insulin resistance. GLP-1 agonists can pose a few side effects that could be severe and life-threatening in some cases when used without a doctor's supervision. A healthcare professional is best positioned to monitor how you respond to treatment and make the correct adjustments when necessary.

Lifestyle and Diet Considerations While on Wegovy

When incorporating Wegovy into a plan to address insulin resistance, consider having a balanced and nutrient-dense diet that includes a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. Limit processed foods, sugary snacks, refined carbohydrates, and, most importantly, alcohol. Also, practice mindful eating and be aware of portion sizes to avoid overeating.

"These GLP-1 agonist medications are absolutely wonderful. Occasionally, they can cause a drop in blood sugar. You want to be very careful about that, and particularly not to drink alcohol while on these medications because that will cause hypoglycemia," says Dr. Cywes. "Also, it is malpractice to use a GLP-1 agonist (like Wegovy) without therapeutic carbohydrate restriction," he added.

Other lifestyle changes that can maximize the effect of Wegovy on insulin sensitivity and improve your overall health:

  • Engage in regular physical activities, including aerobic exercises (such as walking, jogging, or cycling) and strength training. Exercise helps improve insulin sensitivity and contributes to overall weight management.
  • Get enough quality sleep each night. Inadequate sleep can affect insulin sensitivity.
  • Stay well-hydrated by drinking an adequate amount of water throughout the day.

Conclusion

Wegovy is an innovative medication that offers hope for individuals struggling with insulin resistance and obesity. By assisting with weight loss, appetite control, and blood sugar regulation, it can help improve insulin sensitivity and overall health. However, it's crucial to remember that it's not a magic solution and should be combined with a healthy lifestyle. Please consult your healthcare provider to find out if Wegovy is a good option for you, and work together with them to develop a comprehensive plan for managing insulin resistance effectively.

Sources

To ensure that we give you correct, accurate, and relevant information, all articles on Diabetic & Me are backed by verified information from academic research papers, well-known organizations, research institutions, and medical associations.

  1. Access Data FDA Prescribing Information for Wegovy (Semaglutide) Injection, for Subcutaneous Use
  2. novoMEDLINK Wegovy EFFICACY & SAFETY

About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

View All Articles