Ozempic for Type 2 Diabetes: 4 Ways Ozempic Works to Improve Blood Glucose Levels

When you eat food, it sets off an important chain of events within your body. As your blood glucose (sugar) levels start to rise, gut hormones called incretins jump into action. Their primary job involves signaling the pancreas to release insulin — otherwise known as the “incretin effect.” 

The incretin effect helps keep your blood glucose levels from getting too high after you eat. But for people living with Type 2 diabetes, the incretin effect may not produce this same result. And some people may not have an incretin effect at all.

Ozempic (semaglutide) is a medication that’s made to act like an incretin called glucagon-like peptide-1 (GLP-1). For people with Type 2 diabetes, Ozempic can help provide the benefits of the incretin effect — in the form of a once-weekly injection. Here’s how it works.

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1. Ozempic tells your pancreas to release insulin after you eat

Insulin has an important job in the body. It serves as the key that unlocks our cells, allowing glucose to enter and be used for energy — or stored for later. After we eat, our blood glucose levels rise. The pancreas normally releases insulin in response to keep this all in balance.

If you have Type 2 diabetes, your pancreas may not be releasing enough insulin to handle the glucose in your blood. This is where Ozempic can help. It tells the pancreas to release more insulin after you eat, helping to lower post-meal blood glucose spikes.

Ozempic’s effect on insulin release only happens when your blood glucose goes up, such as after a meal. Because of this, Ozempic has a much smaller risk of hypoglycemia (low blood glucose) compared to diabetes medications, such as sulfonylureas. This is because sulfonylureas trigger insulin release whether you’ve eaten or not.

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2. Ozempic reduces the amount of glucose your liver makes

In addition to insulin, your pancreas also releases glucagon to keep your blood glucose levels in balance. One of glucagon’s jobs is to tell your liver to make glucose when your body’s stores are running low. People with Type 2 diabetes tend to make more of their glucose this way, which can contribute to higher blood glucose levels.

Ozempic reduces the amount of glucagon released by the pancreas. This, in turn, lowers the amount of glucose made by your liver.

3. Ozempic slows the movement of food out of your stomach

Ozempic can slow gastric emptying, which is how quickly food moves out of your stomach. This can slow down how fast you absorb carbohydrates from food, which can help improve blood glucose levels after you eat. You may also feel full for longer.

But slowed gastric emptying from Ozempic doesn’t appear to be a long-term effect. It’s usually more pronounced after you start Ozempic and should lessen as your body gets used to treatment. This effect can also contribute to some of Ozempic’s side effects, such as nausea, which also usually improve over time.

4. Ozempic targets the areas of the brain that regulate appetite and fullness

Some people report changes in their appetite and cravings after starting Ozempic. This is thought to be due to how Ozempic affects areas of the brain responsible for regulating appetite and fullness. Ozempic may also lessen cravings or preferences for certain foods, such as fatty, energy-dense foods that can add extra calories.

These effects can result in weight loss for some people taking Ozempic. In fact, Ozempic’s effect on body weight is one of the reasons it may be prescribed in the first place. Even a small amount of weight loss can help make blood glucose levels easier to manage. And you may notice improvements in your blood pressure and cholesterol, too.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Farah Naz Khan, MD

Farah Naz Khan, MD, is a board-certified physician at the UW Medicine Diabetes Institute and a clinical assistant professor of metabolism, endocrinology, and nutrition at the University of Washington.

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