Written and medically assessed by W. van Donselaar, MD, BIG 79020681301, on 07-05-2026.
Ozempic contains the substance semaglutide. Doctors in the Netherlands prescribe it for type 2 diabetes. It helps regulate your blood sugar when diet, exercise and other drugs do not do enough. It works in several places at once. If you have diabetes, the route is usually through your own GP. We mainly come into the picture on the weight side.
How does Ozempic regulate your blood sugar?
Your intestines produce a hormone after eating: GLP-1. That hormone helps keep your blood sugar stable. It does three things:
It prompts your pancreas to make insulin, but only when your blood sugar is too high.
It inhibits another hormone (glucagon) that actually raises your blood sugar.
It drains your stomach more slowly, so your blood sugar does not rise as much after eating.
In type 2 diabetes, this system does not work as well. Your cells respond less to insulin. And your own GLP-1 does less than it should. As a result, your blood sugar rises too far after a meal.
Semaglutide mimics that hormone. But it works stronger and longer. One injection a week is enough. The main difference with insulin: semaglutide only works when your blood sugar is high. Insulin always lowers your blood sugar. As a result, the risk of blood sugar being too low (hypoglycaemia) with Ozempic is small, as long as you use it alone.
What does it deliver?
In studies, blood sugar dropped markedly. The HbA1c (your average blood sugar over 10 to 12 weeks) went down one to almost two points on average. That was over six months to over a year. People also lost an average of three to six kilos.
These are averages. Some people notice more, others less. What you achieve depends on your starting values, your dose, your lifestyle and your body. Some people see lower blood sugar after just a few weeks. You will only see the full effect after three to six months.
Do you have an increased risk of cardiovascular disease in addition to diabetes? Then there is another benefit. Studies in that group showed that semaglutide lowers the risk of heart attack or stroke. Whether that applies to you will be assessed by your doctor based on your situation.
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Where does Ozempic fit into treatment?
Type 2 diabetes almost never starts with Ozempic. The Dutch guideline follows a fixed order:
Lifestyle first: nutrition, exercise and weight loss.
Metformin: the first medicine if lifestyle is not enough.
There if that does too little: this is where a GLP-1 drug such as semaglutide comes into the picture. Other options include an SGLT2 inhibitor, other blood sugar-lowering tablets or insulin.
Combinations or insulin: at a later stage.
Which choice fits depends on your blood sugar, weight and other conditions. Are you overweight or have heart problems? Then a doctor is more likely to choose a GLP-1 drug. Metformin and semaglutide together is a common combination. They reinforce each other.
Beware of combinations with insulin or certain tablets. This increases the risk of low blood sugar. Your doctor will then often lower the dose of the other drug. Never adjust your insulin yourself when starting Ozempic.
How does a trajectory work?
Ozempic starts low and goes up in steps:
| Phase | Dose per week | Target |
|---|---|---|
| Week 1-4 | 0.25 mg | Getting used |
| Week 5-8 | 0.5 mg | First active dose |
| Thereafter, as necessary | 1.0 mg, sometimes up to 2.0 mg | Increase according to your blood sugar |
Your doctor sets the pace, not you. After three to six months, you check how it goes together. If it works well, you can continue using it for a long time. With type 2 diabetes, this is quite normal. Ozempic is not a cure.
An example. A 61-year-old man with type 2 diabetes was already taking metformin. Yet his blood sugar remained too high. His GP switched him to semaglutide. After 12 weeks, his HbA1c had dropped and he had lost around five per cent weight. Whether the same will happen to you depends on many things.
What are the side effects?
Gastrointestinal complaints are the most common. Nausea, diarrhoea, constipation and abdominal pain are very common: in more than one in 10 users. They are usually mild. They occur mostly in the first weeks and after higher doses. In most people, they subside again.
Two combinations require attention:
With insulin or certain tablets: the risk of low blood sugar increases. Your doctor will then adjust the dose.
With previous pancreatitis: Inflammation of the pancreas and gallstones sometimes occur. In case of persistent, severe abdominal pain, call your doctor immediately.
A full overview can be found in the side effects of Ozempic.
Do the check If you want to know if a supervised pathway alongside your diabetes treatment is for you.
What remains important?
Ozempic is a tool, not a solution in itself. Diet, exercise and weight remain the basics. If you stop without making lifestyle changes, your blood sugar often rises again.
Three things that always come back in a journey:
Monitoring your blood sugar, kidney function and weight.
Matching your medicines to each other in combinations.
Consult with your doctor for any change, whether it is a higher dose or stopping.
Want to know what's in the remedy and how to store it? Check out the Ozempic medication review. For a route with Ozempic injections with weight coaching, you can schedule an intake.
More questions on Ozempic use in diabetes
Can Ozempic replace my other diabetes medication?
Can Ozempic replace my other diabetes medication?
That depends on your situation and is determined by your doctor. Sometimes it replaces metformin, more often it is added. When combined with insulin, your doctor often adjusts the dose to prevent low blood sugar.
Does Ozempic lower the risk of cardiovascular disease?
Does Ozempic lower the risk of cardiovascular disease?
In people with type 2 diabetes and an increased risk, this has been seen in research. Whether it applies to you will be assessed by your doctor based on your situation.
I have type 1 diabetes, can I use Ozempic?
I have type 1 diabetes, can I use Ozempic?
No, not as an independent treatment. Ozempic is for type 2 diabetes. In type 1, it does not replace insulin. Combining it with rapid insulin withdrawal can be dangerous.