Hypoglycemia Risk with Wegovy (Semaglutide)

Mechanism of Action and Hypoglycemia Risk

GLP-1 receptor agonists, including semaglutide, have minimal risk for hypoglycemia when used as monotherapy, as stated by the American Diabetes Association 1

Combination therapy with GLP-1 receptor agonists, such as semaglutide, and insulin or sulfonylureas may increase the hypoglycemic potential, according to the American Diabetes Association 1
Patients taking incretin mimetics (GLP-1) with insulin secretagogues or insulin may experience hypoglycemia, as noted by the American Diabetes Association 2, 3
To reduce hypoglycemia risk, the American Diabetes Association recommends consuming moderate amounts of carbohydrates at meals and snacks, not skipping meals, and carrying a source of carbohydrates during physical activity for individuals taking GLP-1 receptor agonists with insulin secretagogues 2

Clinical trials have demonstrated that all GLP-1 receptor agonists, including semaglutide, have minimal risk for hypoglycemia when used alone, as reported by the American Diabetes Association 4
The absolute risk of hypoglycemia with semaglutide monotherapy remains low due to its glucose-dependent mechanism of action, according to the American Diabetes Association 1

When prescribing Wegovy with medications that increase hypoglycemia risk, such as insulin or sulfonylureas, the American Diabetes Association recommends considering lower doses of the insulin or insulin secretagogue, educating patients on recognizing and managing hypoglycemia symptoms, and advising patients to monitor blood glucose more frequently 1, 4
For patients experiencing hypoglycemia while on combination therapy, the American Diabetes Association recommends using glucose tablets or carbohydrate-containing foods or beverages 2