Hello Health Rounds readers! Today we feature a trial looking at another potential patient population for Novo Nordisk's GLP-1 drug semaglutide that was presented at a major diabetes meeting. We also highlight a study that found a standard practice prior to surgery may not be needed at all. 

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People with type 1 diabetes who need to lose weight can benefit from the blockbuster GLP-1 drug semaglutide currently approved only for type 2 diabetes, according to results from a small trial.

Semaglutide is the active ingredient in Novo Nordisk's diabetes drugs Ozempic and Rybelsus, as well as its weight-loss treatment Wegovy.

In the first clinical trial testing the Novo drug in people with type 1 diabetes and obesity, the 36 patients who received weekly semaglutide injections along with their usual insulin spent more time in their target blood sugar range and lost more weight than 36 similar patients who got a placebo along with their insulin, study leader Dr. Viral Shah of Indiana University School of Medicine reported at the American Diabetes Association  meeting in Chicago.

All of the patients were using automated insulin delivery systems and had a body mass index of 30 or higher, which is considered obese.

One-third of the patients in the semaglutide group achieved all three of the study’s goals: blood sugar in the target range of 70 to 180 mg/dL more than 70% of the time, dangerously low blood sugar less than 4% of the time, and body weight reduction of at least 5%. The average weight loss with semaglutide was 20 pounds (9 kg).

No one in the placebo group achieved all three of these milestones, according to a report of the study published in NEJM Evidence.

"We hope that our trial will encourage the industry to conduct a regulatory approval trial so that this drug could be available as an adjunct to insulin therapy to optimize Type 1 diabetes management," Shah said in a statement.

The decades-old practice of having patients fast before surgery might not do what it’s supposed to do, a new analysis suggests.

Surgeons have patients stop eating hours before an operation in order to avoid so-called aspiration pneumonia, which happens when anesthesia causes vomiting and the vomit contents are inhaled into the lungs. The belief is that an empty stomach would lower that risk.

For the analysis, researchers pooled data from 17 studies involving 990 patients who fasted before surgery and 801 who did not.

Aspiration occurred in 0.5% of non-fasting patients and 0.7% of those who fasted, the researchers reported in Surgery.

No particular fasting regimen was better than the others at preventing aspiration, the researchers found.

“At some point, almost everybody will undergo a procedure and there are universal policies in every healthcare facility that require some degree of fasting before surgery,” study leader Dr. Edward Livingston of the David Geffen School of Medicine at UCLA said in a statement.

“Fasting for long periods of time is extremely uncomfortable and patients really don't like to do it. Our research suggests that long periods of fasting may not be necessary.”