Can People With Prediabetes Take Ozempic?

Learn about prediabetes and common risk factors, whether Ozempic or metformin is recommended to take with prediabetes, and tips for managing prediabetes.

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Sarah Bullard, MS, RD, LD
— Signos
Dietitian and Nutrition Writer
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Updated by

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Science-based and reviewed

May 20, 2024
May 10, 2024
— Updated:

Table of Contents

More than one in three American adults have prediabetes, a health condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed with type 2 diabetes. Prediabetes increases your risk of developing type 2 diabetes, heart disease, and stroke.1

Ozempic is an FDA-approved, once-weekly injection medication for people with type 2 diabetes to help manage their blood sugar levels.2 The main active ingredient is semaglutide, the same ingredient used in Wegovy to help people lose weight.3 

You may wonder if Ozempic is a suitable choice for managing prediabetes and preventing other health conditions. 

Keep reading to learn more about prediabetes and common risk factors, whether Ozempic or metformin is recommended to take with prediabetes, and tips for managing prediabetes.


Understanding Prediabetes

Prediabetes has less clear symptoms than type 2 diabetes, meaning you may not feel any different. 

Before developing type 2 diabetes, almost all people have prediabetes with blood glucose levels higher than normal but not yet high enough to be diagnosed as diabetes.1, 4 Approximately 10% of people with prediabetes progress to type 2 diabetes each year.5

Prediabetes is similar to a warning light on your vehicle. There may not be major issues, but continuing to drive without making repairs or changes will lead to problems. 

If you are diagnosed with prediabetes, early treatment and lifestyle changes can help your blood sugar levels return to normal ranges. Healthcare professionals often check for prediabetes to help prevent or delay developing type 2 diabetes for many years or decades.1, 4

An A1C test can diagnose prediabetes or type 2 diabetes and provide information about your average blood sugar level over the past three months. 

  • An A1C less than 5.7% is normal. 
  • An A1C of 5.7 to 6.4% indicates prediabetes.
  • An A1C of 6.5% or higher indicates type 2 diabetes.6

What you eat and drink influences your blood sugar and A1C levels. The digestive systems break down food and drinks with carbohydrates into sugar, which is then released into the bloodstream. 

The pancreas releases insulin in response to the amount of sugar in the blood. Insulin allows your cells to use the sugar in the blood and appropriately reduce the blood sugar level. Carbohydrate digestion is altered with type 2 diabetes due to insufficient insulin, or the body cannot use insulin properly.7 

Identifying alterations in how your body processes carbohydrates can help you make diet and lifestyle changes to reduce the amount of sugar in your blood and help prevent or delay type 2 diabetes. For optimal health, blood sugars should stay in a target range (not too low or too high).1, 4

Risk Factors for Prediabetes

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Common risk factors put you at an increased risk for prediabetes. If you have any of the following risk factors, getting an A1C test will help identify prediabetes sooner. They include: 

  • Carrying extra weight (your healthcare provider can let you know how much weight for your gender and height).
  • Being 45 years or older.
  • A parent or sibling with type 2 diabetes.
  • Less than three physically active sessions a week.
  • Ever having gestational diabetes (diabetes during pregnancy).
  • Giving birth to a baby weighing more than 9 pounds.
  • Diagnosed with polycystic ovary syndrome (PCOS)
  • Certain races or ethnicities (African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans).1 

Pay closer attention to your blood sugar level and ask for testing if you have any of these risk factors for prediabetes. 

Is Ozempic Safe for Prediabetes?

If you were diagnosed with prediabetes, you might be looking into all possible tools to help you prevent type 2 diabetes and improve your overall health. 

Ozempic is a tool (medication) made by Novo Nordisk for people with type 2 diabetes to help manage their blood sugar levels, and the main active ingredient is used in Wegovy to help people lose weight.2, 3 

Approved Uses for Ozempic (And Similar Medications)

The Food and Drug Administration (FDA) has approved Ozempic for lowering blood sugar levels in adults with type 2 diabetes due to the way it works as a GLP-1 Receptor Agonist. Using Ozempic for a reason not approved by the FDA is an off-label use, and off-label uses are often not covered by insurance companies.8

The FDA has approved Wegovy in adults and children 12 years and older with obesity or adults with excess weight (overweight) who also have weight-related medical issues (high blood pressure, heart disease, or sleep apnea) to lose weight.8 

Someone with prediabetes may meet the requirements for Wegovy if they are obese or overweight with weight-related medical problems. 

Someone with prediabetes may meet the FDA guidelines for Ozempic if their blood sugar or A1C level is considered type 2 diabetes. A recent test will provide data for a healthcare provider to determine if you have type 2 diabetes. 

How Ozempic Works

Semaglutide mimics the GLP-1 hormone (glucagon-like peptide-1) that suppresses appetite and intake. Ozempic works in three ways to lower blood sugar levels:

  1. It helps your pancreas make more insulin in response to increased blood sugar levels. Insulin helps your body use carbohydrates effectively. 
  2. It prevents your liver from making and releasing too much sugar into your blood.
  3. It slows down food leaving your stomach, so you stay full longer and have lower blood sugar levels after meals.2 

Ozempic could help lower blood sugar levels in people with prediabetes. Since the same ingredient is in Ozempic and Wegovy, it is logical to consider it safe to treat prediabetes. 

As with all medications, Ozempic and Wegovy may cause serious or mild side effects. The prescribing information for both medications discourages use if you have a history or family member with thyroid cancer, as thyroid tumors are a severe side effect of these medications.2, 3 

Other side effects are inflammation of the pancreas, gallbladder problems, and kidney problems. The most common side effects are nausea, constipation, vomiting, and other gastrointestinal issues.2, 3 

Share all health concerns, medical history, and questions with your healthcare provider to decide if Ozempic or any medication is right for you.

Which Is Better for Prediabetes: Metformin or Ozempic?

Another medication, metformin, has been approved for use in type 2 diabetes since 1994.9 

Metformin is an oral medication that lowers fasting and after-meal blood sugar levels. It works by:

  1. Reducing the amount of sugar the liver makes and releases.
  2. Reduces the amount of sugar the intestines absorb.
  3. It helps your body use insulin better.
  4. Increases the GLP-1 hormone, which suppresses appetite.9

Metformin is not approved for use in prediabetes, although the American Diabetes Association recommends it be used to prevent type 2 diabetes in adults. Metformin has extensive, lengthier studies supporting its use and safety, while Ozempic has less research and long-term studies observing its effect on the body and when ceasing its use.2, 9   

Metformin is generally considered safe, well-tolerated, and affordable. Some side effects, such as diarrhea, nausea, and vomiting, affect people taking it but typically subside.9 Research shows it reduces the risk of developing type 2 diabetes by 31%.10

Ozempic generally costs around $1,000 monthly if insurance doesn’t cover its use.11 Metformin costs about $10 monthly without insurance coverage.12

A 30-week study of 397 adults with type 2 diabetes found that Ozempic taken with metformin or insulin lowered A1C levels better than metformin or insulin alone.2  

Ozempic may be more effective in lowering A1C, but benefits and disadvantages (cost, accessibility, and other health conditions) must be considered. 

Discuss with your healthcare provider which medication is the best option for you.

<p class="pro-tip"><strong>Also Read: </strong><a href=non-diabetic-track-their-glucose>Why Would a Non-Diabetic Want to Track Their Glucose?</a>.</p>

Other Ways to Manage Prediabetes

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Medication is just one way you can help you manage prediabetes and prevent type 2 diabetes. Other effective tools include losing weight, diet changes, increasing exercise levels, and stopping smoking. 

The American Diabetes Association recommends following the guidelines for the Diabetes Prevention Program. Following the recommendations can lower your risk of developing type 2 diabetes by 58%.1 

1. Losing Weight

Losing 5 to 7% of your body weight if you are overweight lowers your risk of developing type 2 diabetes. For an average adult weighing 200 pounds, this means losing 10 to 14 pounds. 

Changing your eating and adding more movement can help you with weight management. Weight loss helps your body manage insulin and blood sugar levels better.

2. Diet Changes

The plate method is a simple visual for ensuring a filling and nutritious meal with 

enough protein, fiber, and carbohydrates to stay full between meals and regulate blood sugar levels.12 

Regulating your carbohydrate-rich foods and drinks will help your body return to target A1C, insulin, and blood sugar levels. 

You can start independently by following the plate method when planning meals. Working with a registered dietitian can help you individualize your eating plan. 

  • Fill one-half of your plate with non-starchy vegetables like broccoli, cauliflower, spinach, tomatoes, and green beans. 
  • Fill one-quarter of your plate with starchy vegetables, grains, or fruit, such as sweet potatoes, oatmeal, brown rice, or berries.
  • Fill the final one-quarter with a lean protein option (animal or plant-based) like beans, chicken, fish, low-fat dairy, and eggs.

3. Exercising Frequently

Regular physical activity is 150 minutes a week of fast walking (or similar activities). 

You can divide these minutes however you want. Try 30 minutes daily, five days a week, or do three 50-minute walks!

Physical activity reduces your blood sugar levels and helps your body use carbohydrates properly.1 

4. Stop Smoking

Smoking is one cause of type 2 diabetes; people who smoke are 30 to 40% more likely to develop type 2 diabetes than people who do not smoke. 

Smoking also makes it harder to manage blood sugar levels. Nicotine changes cells so they don’t respond properly to insulin, increasing blood sugar levels. 

Chemicals in cigarettes also lead to inflammation, making it harder to control blood sugar levels.13 

Work on reducing or quitting smoking altogether to manage your prediabetes.

Learn More About How to Improve Blood Sugar Health With Signos’ Expert Advice

A Signos continuous glucose monitor (CGM) can help you track blood sugar levels. 

Tracking your blood sugar response can help you balance your meals and achieve healthy weight loss. You can see how diet, exercise, and healthy changes like quitting smoking impact your body.

This tool (CGM) can help you make effective changes, such as balancing your plate with protein, fiber, and carbohydrates. These changes will help you feel your best and prevent type 2 diabetes.

A Signos’ CGM can help you improve your health and prevent type 2 diabetes and related health conditions. A healthcare professional can help you choose the proper weight loss medication (if needed) to help manage your health conditions, blood sugar levels, and weight. 

Learn more about nutrition and healthy habits on Signos’ blog. Take a quick quiz to determine if Signos fits your needs.

<p class="pro-tip"><strong>Learn More: </strong><a href=what-causes-high-glucose-levels>What Causes High Glucose Levels: Learn About Hyperglycemia</a>.</p>

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About the author

Sarah Bullard is a registered dietitian and nutrition writer with a master’s degree in nutrition. She has a background in research and clinical nutrition, personalized nutrition counseling, and nutrition education.

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Please note: The Signos team is committed to sharing insightful and actionable health articles that are backed by scientific research, supported by expert reviews, and vetted by experienced health editors. The Signos blog is not intended to diagnose, treat, cure or prevent any disease. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider. Read more about our editorial process and content philosophy here.

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