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Important to note that this side effect is still very rare and that we still use drugs with similarly serious and rare side effects. The authors of the study d

Important to note that this side effect is still very rare and that we still use drugs with similarly serious and rare side effects. The authors of the study do not recommend abandoning these drugs, rather we should understand and manage the risks.

lawlessone 2y ago
Doesn't untreated diabetes also cause blindness in some people? definitely seems better to take it than not.
- Baeocystin 2y ago
  It does. High blood sugar levels are hard on every system in the body. One thing about semaglutide is that it can lower blood sugar levels past normal, too. One of my diabetic friends had to lower her dose of Ozempic precisely for this reason. In general, it wouldn't surprise me if pathologies that involve ischemia could be exacerbated by a treatment that lowers energy supply as well.
  - xattt 2y ago
    Obesity goes hand in hand with hypertension, so this is a double-whammy for organs with particularly sensitive microstructures (like eyes but also kidneys).
  - tssva 2y ago
    Lowering blood sugar below normal levels is hardly unique to semaglutide or GLP1s in general. Most drugs targetting type 2 diabetes can do so and sometimes need to be adjusted to prevent hypoglycemic events. Insulin in particular poses a significant risk of hypoglycemic events which is why many insurances cover continuous glucose monitors for those taking insulin.
  - NewsaHackO 2y ago
    GLP1 agonists on its own, has a very low chance of cause significant hypoglycemia because it's action the blood glucose dependent. It almost exclusively happens when patient are taking another agent is taking a diabetic medication that has a proven track record of causing hypoglycemia on it's own
- Mistletoe 2y ago
  And obesity has passed smoking as the leading cause of preventable death in the US.
- thund 2y ago
  Different damages, one is on blood vessels, the other on optic nerve. So you could even get both
- akira2501 2y ago
  > seems better to take it than not. If you have debilitating diabetes that has failed to respond to changes in exercise and diet. If your taking the drug as some type of "weight loss short cut" you should possibly reconsider that position.
jdietrich 2y ago
Also important to note that these studies are observational and do not prove causation. While the authors attempted to correct for covariates, it is highly likely that the patients who received semaglutide were generally sicker than those who did not. While further study is necessary and some degree of caution may be warranted, it is still entirely plausible that semaglutide has no causal influence on NAION.
- harvey9 2y ago
  Threshold for semaglutide use seems pretty low. And the article mentioned that its 'usually' diabetes patients which I took to mean it even included users who were overweight but not diabetic.
- TeaBrain 2y ago
  The endlessly repeated truism that "these studies don't prove causation" isn't really saying anything, as the same could be said for every long term human drug study. This line of thinking was the reasoning behind ignoring the link between cancer and tobacco products for decades, because the studies establishing that link were and are observational studies, considering that a controlled experimental study on humans establishing the same would be completely unethical.
  - jdietrich 2y ago
    >This line of thinking was the reasoning behind ignoring the link between cancer and tobacco products for decades I wish people would stop repeating this falsehood. The mass consumption of tobacco only really started after 1910, with the mechanisation of cigarette manufacturing. There was a multi-decade time lag between this explosion in tobacco use and the long-term sequelae of lung cancer and cardiovascular disease. The causal link was established beyond any reasonable doubt in the late 1950s, which was really the earliest point at which we had clear data; it took only a few years for all major medical bodies to endorse this as the consensus position and start lobbying for legislative action. "We didn't know" is a propaganda line rolled out by the tobacco industry, the asbestos industry, the fossil fuel industry and others. The lack of action wasn't due to any scientific uncertainty, but naked corruption at the highest level. There was an overwhelmingly clear scientific consensus which was privately accepted as true by these industries, but they paid off politicians to protect their profits. We genuinely don't know if this is a real risk; NAION is a rare disease, which greatly increases the difficulty of making accurate inferences even from very large amounts of data. We can be extremely confident that the magnitude of risk is vastly smaller than the risks caused by Type 2 diabetes and obesity.
nohuck13 2y ago
The base rate is 1.5 to 2.5 cases per 10,000 people per year, according to the article.
- operator-name 2y ago
  To make that clear: > The researchers estimate that for every 10,000 people treated in a year, between 1.5 and 2.5 _extra_ cases will be seen. The existing rate is about 2 per 10,000 people per year: > Both Danish studies show that the risk of developing NAION for the individual patient receiving treatment with Ozempic is only 0.2 per thousand per year, which is fortunately significantly lower than in the American study. NAION is a relatively rare condition, and the extra risk is therefore low.
thesuitonym 2y ago
This was addressed in the article: "This is a serious but very rare side effect. Often, we only learn about this kind of thing after a new drug has been on the market for a few years, as is the case with Ozempic. It should be emphasised that it is neither more serious nor more common than the rare side effects of many other medicines that we continue to use. It is, so to speak, just a new piece of the puzzle of understanding how this drug works, explains Anton Pottegård."

lawlessone 2y ago

Doesn't untreated diabetes also cause blindness in some people? definitely seems better to take it than not.

Baeocystin 2y ago
It does. High blood sugar levels are hard on every system in the body. One thing about semaglutide is that it can lower blood sugar levels past normal, too. One of my diabetic friends had to lower her dose of Ozempic precisely for this reason. In general, it wouldn't surprise me if pathologies that involve ischemia could be exacerbated by a treatment that lowers energy supply as well.
- xattt 2y ago
  Obesity goes hand in hand with hypertension, so this is a double-whammy for organs with particularly sensitive microstructures (like eyes but also kidneys).
- tssva 2y ago
  Lowering blood sugar below normal levels is hardly unique to semaglutide or GLP1s in general. Most drugs targetting type 2 diabetes can do so and sometimes need to be adjusted to prevent hypoglycemic events. Insulin in particular poses a significant risk of hypoglycemic events which is why many insurances cover continuous glucose monitors for those taking insulin.
- NewsaHackO 2y ago
  GLP1 agonists on its own, has a very low chance of cause significant hypoglycemia because it's action the blood glucose dependent. It almost exclusively happens when patient are taking another agent is taking a diabetic medication that has a proven track record of causing hypoglycemia on it's own
Mistletoe 2y ago
And obesity has passed smoking as the leading cause of preventable death in the US.
thund 2y ago
Different damages, one is on blood vessels, the other on optic nerve. So you could even get both
akira2501 2y ago
> seems better to take it than not. If you have debilitating diabetes that has failed to respond to changes in exercise and diet. If your taking the drug as some type of "weight loss short cut" you should possibly reconsider that position.

jdietrich 2y ago

Also important to note that these studies are observational and do not prove causation. While the authors attempted to correct for covariates, it is highly likely that the patients who received semaglutide were generally sicker than those who did not. While further study is necessary and some degree of caution may be warranted, it is still entirely plausible that semaglutide has no causal influence on NAION.

harvey9 2y ago
Threshold for semaglutide use seems pretty low. And the article mentioned that its 'usually' diabetes patients which I took to mean it even included users who were overweight but not diabetic.
TeaBrain 2y ago
The endlessly repeated truism that "these studies don't prove causation" isn't really saying anything, as the same could be said for every long term human drug study. This line of thinking was the reasoning behind ignoring the link between cancer and tobacco products for decades, because the studies establishing that link were and are observational studies, considering that a controlled experimental study on humans establishing the same would be completely unethical.
- jdietrich 2y ago
  >This line of thinking was the reasoning behind ignoring the link between cancer and tobacco products for decades I wish people would stop repeating this falsehood. The mass consumption of tobacco only really started after 1910, with the mechanisation of cigarette manufacturing. There was a multi-decade time lag between this explosion in tobacco use and the long-term sequelae of lung cancer and cardiovascular disease. The causal link was established beyond any reasonable doubt in the late 1950s, which was really the earliest point at which we had clear data; it took only a few years for all major medical bodies to endorse this as the consensus position and start lobbying for legislative action. "We didn't know" is a propaganda line rolled out by the tobacco industry, the asbestos industry, the fossil fuel industry and others. The lack of action wasn't due to any scientific uncertainty, but naked corruption at the highest level. There was an overwhelmingly clear scientific consensus which was privately accepted as true by these industries, but they paid off politicians to protect their profits. We genuinely don't know if this is a real risk; NAION is a rare disease, which greatly increases the difficulty of making accurate inferences even from very large amounts of data. We can be extremely confident that the magnitude of risk is vastly smaller than the risks caused by Type 2 diabetes and obesity.

nohuck13 2y ago

The base rate is 1.5 to 2.5 cases per 10,000 people per year, according to the article.

operator-name 2y ago
To make that clear: > The researchers estimate that for every 10,000 people treated in a year, between 1.5 and 2.5 _extra_ cases will be seen. The existing rate is about 2 per 10,000 people per year: > Both Danish studies show that the risk of developing NAION for the individual patient receiving treatment with Ozempic is only 0.2 per thousand per year, which is fortunately significantly lower than in the American study. NAION is a relatively rare condition, and the extra risk is therefore low.

thesuitonym 2y ago

This was addressed in the article: "This is a serious but very rare side effect. Often, we only learn about this kind of thing after a new drug has been on the market for a few years, as is the case with Ozempic. It should be emphasised that it is neither more serious nor more common than the rare side effects of many other medicines that we continue to use. It is, so to speak, just a new piece of the puzzle of understanding how this drug works, explains Anton Pottegård."