For those of us with Type 1 Diabetes (T1D), insulin therapy has always been the only treatment option available. But with the rise of GLP-1 medications such as Ozempic, a whole new world is being explored. While GLP-1s are FDA-approved for Type 2 Diabetes, a growing body of research and evidence suggests they may also offer significant benefits for people with T1D. From improving glycemic control to helping with insulin resistance and weight management, GLP-1s present a promising option to use in combination with insulin (although they are still considered off-label at this time).
So, how do you approach your endocrinologist about this? It’s not as simple as just asking for a prescription. This conversation requires a good understanding of the medication, its potential benefits and risks for T1D, and a clear, well-articulated case for how it could improve your personal health.
This blog post will walk you through everything you need to know to have a productive and informed discussion with your healthcare provider about how to get prescribed Ozempic.
Understanding Ozempic and T1D
Ozempic is a GLP-1 receptor agonist. It works by mimicking a natural hormone that our bodies make to help with blood sugar regulation and appetite control.
Although there are possible side effects and risks involved, and it is not a cure or an insulin replacement, Ozempic is sometimes used off-label in people with type 1 diabetes to potentially help with:
- Improving blood sugar control and lowering A1C
- Helping reduce insulin resistance
- Promoting weight management
- Reducing insulin needs
Preparing for the Conversation
Make sure to do your homework and be prepared for the conversation with your provider. Consider the following:
- Detailed Weight History: Be ready to discuss your weight journey. If you struggle with your weight, how long has it been going on for? What fluctuations have you experienced? What efforts (diet, exercise, other medications) have you made in the past to lose weight, and what were the outcomes?
- Impact on Your Life: Be specific about how your weight, as well as your diabetes, impacts your daily life. Does it affect your energy levels, mobility, joint pain, sleep, or mood? Are you concerned about future health risks? This helps frame it beyond just a number on the scale.
- Recent Labs: Review and be familiar with your recent lab results (A1C, cholesterol, etc.).
- The More Data the Better: Keep a record of your current insulin regimen, exercise habits, diet, and CGM data.
- Family History: Do you have a family history of type 2 diabetes, heart disease, or other weight-related conditions? This could be a relevant factor for your doctor to consider in terms of preventative care.
- Do Your Research: Briefly mention why you believe this medication might be a good fit for you. Mention some of the recent research you have seen on GLP-1s and T1D.
How to get Prescribed Ozempic: A Step-by-Step Guide for Having the Conversation
- Start with a positive and collaborative tone.
- Emphasize that you want to work together to find the best solution for your health.
- Frame it as an exploration of new options, not a demand for a prescription.
- Present your case with the data you gathered.
- Share your CGM data and personal goals.
- Explain your challenges and how Ozempic might help address them (e.g., “I’m struggling with insulin resistance, and I’ve read that Ozempic can help improve insulin sensitivity.”)
- Address the possible risks.
- Show that you are aware of the potential risks (hypoglycemia, DKA, side effects such as nausea, etc) and have thought about how to mitigate them.
- Discuss the need for careful dose adjustments and close monitoring.
- Ask informed questions.
- Instead of “Can I have GLP-1?”, try questions like:
- “What are your thoughts on GLP-1 agonists for T1D based on the latest research?”
- “Given my current health, do you think I’d be a good candidate for this medication?”
- “What are the specific criteria that would allow me to qualify for GLP-1 medication, and what steps could we take to get there?
- “How would we adjust my insulin regimen if we were to try this?”
- “What would the monitoring plan look like?”
- “What are the potential benefits and risks of GLP-1s for someone in my specific situation?”
- Instead of “Can I have GLP-1?”, try questions like:
- Express Your Commitment to Lifestyle Changes
- Reassure your doctor that you are committed to making lifestyle changes alongside any potential medication.
- Let them know that you are fully ready to commit to dietary changes, such as consuming adequate calories and plenty of protein and fiber, and that you will be engaging in regular physical activity to help make sustainable progress.
What to Do if You Get a “No”
What if, after a thoughtful conversation, your endocrinologist still says no? It’s important not to get discouraged. Instead, use it as an opportunity to dig deeper. Politely ask for the specific reasons behind their decision. Is it due to insurance restrictions, potential health risks, or a lack of personal experience with this off-label use?
Understanding their perspective is key. You can then pivot the conversation to explore other potential alternatives that might help you achieve your goals.
Finally, express your continued interest in the topic and ask if this is something you can revisit in the future as more research becomes available.
Remember, your endocrinologist is your partner in healthcare. Approaching the conversation from a place of collaboration and informed self-advocacy will give you the best chance of getting the outcome you desire or, at the very least, a clear understanding of the next steps.
If you still feel your needs weren’t fully addressed, it may be worth considering a second opinion from another provider who specializes in type 1 diabetes management. Chris Szoke is a nurse practitioner who is a fantastic resource that I have personally used.
Insurance Woes
So what if your doctor is finally on board, but you are having trouble with insurance coverage?
You will need to work closely with your provider to ensure their documentation and appeals include language that supports the medical necessity of the medication. They may need to submit a prior authorization and possibly an appeal on your behalf.
Helpful terminology your doctor can incorporate includes:
- “Impaired glucose”
- “insulin resistance” (instead of explicitly stating Type 1 or Type 2 Diabetes)
- “Post-meal glucose spikes”
- “Gradually increasing insulin requirements”
- “Significant weight gain impacting metabolic health”
If insurance continues to deny these medications despite all of your efforts and your provider’s efforts, you can get GLP-1 medications at a discounted price through Lilly Direct or Novo Care, or talk to your healthcare team about safe compounded options.
Conclusion
Navigating the conversation about how to get prescribed Ozempic can feel daunting, but as we’ve explored, the key is to approach your endocrinologist with a prepared, data-driven, and collaborative mindset.
Remember, your healthcare provider is your partner in managing your health. By doing your homework, bringing your data, and showing that you understand both the potential benefits and the risks, you’re not just asking for a prescription, you’re advocating for a new strategy that could lead to better outcomes.
Whether you ultimately get the prescription or not, the conversation itself is a huge step toward more personalized and effective care. You’re taking control of your health journey, and that’s something to be incredibly proud of.
Ready to dive deeper? Check out my free Ultimate Guide to Navigating GLP-1s with T1D, and if you are a woman with T1D looking to connect with others on a similar journey, make sure to join our supportive community in the Mama-Betes GLP-1 T1D Thrive Tribe Facebook Group!