'It comes at a big cost': Diabetic Ozempic users experience stomach paralysis, pancreatitis

Pharmacies limiting Ozempic refills B.C. pharmacies are limiting refills of the diabetes drug that has become popular with people using it off-label to lose weight.

As a Type 2 diabetic, Ozempic has done wonders for Jana Norman's glucose levels. However, she wouldn't compare her experience to anything smoother than a "roller-coaster ride."

"Ozempic was first developed to help control the blood sugars in diabetics, which it does do wonderfully. However, it comes at a big cost," Norman told CTVNews.ca in a phone interview on Aug. 1.

Her endocrinologist recommended she try Ozempic in 2019 since the previous diabetic medications she was on made her gain weight and feel puffy. While at first she felt regular symptoms like nausea, it progressively got worse to the point where she developed gastroparesis, also known as stomach paralysis.

Ozempic, which has been frequently touted by celebrities for its weight loss benefits, is the injectable medication containing semaglutide used to treat people with Type 2 diabetes. The drug, marketed in Canada by Novo Nordisk, lists the severe symptoms people can have while on it, including vomiting, reduced appetite, pancreatitis and gallbladder issues among others.

Kate Hanna, a spokesperson for Novo Nordisk told CTVNews.ca in an email statement on Aug 1. that adverse effects from the use of Ozempic are constantly monitored but gastrointestinal events like delay in gastric emptying are common.

"Gastrointestinal (GI) events are well-known side effects of the GLP-1 class. For semaglutide, the majority of GI side effects are mild to moderate in severity and of short duration," Hanna said.

"While diabetes is a well-known risk factor, there are other risk factors that may increase the risk of gastroparesis such as overweight/obesity, gender (female), virus infection and nervous systems disease (Parkinson's disease or multiple sclerosis)."

WHAT IS GASTROPARESIS?

According to the Canadian Digestive Health Foundation, gastroparesis is a stomach condition where a person's digestive tract is unable to process food into the bowel. Instead, food is left in the stomach for days or weeks causing a form of paralysis.

Dr. Tasneem Sajwani, medical director at the Edmonton Weight Management Centre and Family Practice, explains that gastroparesis as a symptom and condition can differ, as with the slowing of the gastric tract occurring in many cases whereas the paralysis itself is rare.

"It is something that we do see sometimes in patients that have diabetes themselves, so with or without a GLP-1, gastroparesis could be a complication of diabetes itself," Sajwani told CTVNews.ca in a phone interview on Tuesday.

While it's not uncommon for diabetic patients using GLP-1 medications like semaglutide that to develop gastrointestinal side effects, Sajwani says it's important that they to monitor their symptoms and talk to their doctor about whether they need to lower their dose before continuing to use the injection.

"The way they (GLP-1) work is not supposed to make you sick, so if we are using a medication and it is causing significant side effects that are affecting that person's day to day life, then that might not be the right medication to go with, or we're just not at the right dose, or we have to slower the titration," she said.

WEIGHING THE PROS AND CONS

Norman, a 52-year-old resident of Renfrew County, Ont., said she lost 50 pounds during the four years she took Ozempic. However, she would have to constantly put laxatives in her drinks because her body couldn't process any food through her system, leading to frequent hospital visits for enemas.

Her frequent sick days led her to lose her job as a personal support worker in a long-term care home, she says, leaving her feeling guilty for not being able to care for her patients and support her co-workers during a health-care crisis.

"It was quite taxing because I felt bad when I would leave one of my patients or clients without care. I felt like it was my fault, I put the blame on myself for being sick and not being able to care for my people," she said.

Earlier this year, she says she went off the medication for two months but her glucose levels spiked while on insulin and other oral diabetic medications. Her doctor suggested she lower her Ozempic dose from one milligram to 0.25 mg but her gastroparesis persisted. Now she's been off the medication for at least two weeks but her glucose levels are slowly increasing.

Donna Harris also experienced the pros and cons of Ozempic.

The 56-year-old from Roseneath, Ont., said she didn't experience any side effects while on the drug since she started taking it in 2018, until she developed pancreatitis in 2020.

"Everyone's always writing about the vomiting, the dehydration, but everybody misses out on the pancreatitis which they do advertise that it can cause that," Harris said in a phone interview with CTVNews.ca on Aug. 1.

She says while on Ozempic, she also took medication for her blood pressure and cholesterol, as well as metformin to treat her diabetes. Though her doctor didn't specify what caused her pancreatitis, she suspects the various medications she was on likely triggered it.

While off Ozempic for two years, she says her glucose levels were far better than what they are now using insulin.

CONCERNS FOR LONG-TERM EFFECTS

"It's not a great feeling. Even when you want to eat something, after you eat it you feel like you want to throw up, it's just awful," Manuel Janeiro of Ajax, Ont., told CTVNews.ca about his brief experience with Ozempic.

The 57-year-old said he was only on the medication for two months but his persistent nausea, burping and vomiting forced him to take several days off work from his physically tasking job as a drywall installer.

His doctor recommended Ozempic to help him lose weight and treat his diabetes since he has underlying heart issues. Although his glucose levels were fine while on insulin, Janeiro was intrigued by other users' testimonies and advertising.

"The way they make it look so good on the commercial on TV, it's nothing like that at all," he said.

After having been off Ozempic for a few days, Janeiro says he's waiting for his symptoms to go away as the medication is cleansed out of his body, something both Harris and Norman are patiently waiting for too.

"It's not something to mess around with," Norman said. "I'm really worried if they (side effects) are going to be long term, and what has it done to me long term?" she said.

Novo Nordisk states GLP-1 medications have been tested and used for more than a decade and side effects developed from the injection are all temporary.

While Sajwani says there is currently no evidence to support long-term effects of gastrointestinal symptoms directly from GLP-1 medications, all side effects should be considered when deciding if it's the right medication for a patient.

"Whether or not the medication is working for that patient and continues to take it even with the side effects, if they haven't resolved, then that might be something to consider in terms of is it something that they can actually tolerate for a long period of time?" she said.

Norman hopes other Type 2 diabetics considering using Ozempic understand the side effects fully before taking it on.

"I'm not saying that every medication is without a side effect. We all know that the majority of them do have lots of side effects, but do your homework, do your research, really ask a lot of questions and do what's best for you. "