Real world effectiveness of subcutaneous semaglutide in type 2 diabetes: A retrospective, cohort study (Sema-MiDiab01)

Abstract

IntroductionAim of the present study was to evaluate the real-world impact of once-weekly (OW) subcutaneous semaglutide on different end-points indicative of metabolic control, cardiovascular risk factors, and beta-cell function in type 2 diabetes (T2D).MethodsThis was a retrospective, observational study conducted in 5 diabetes clinics in Italy. Changes in HbA1c, fasting blood glucose (FBG), body weight, blood pressure, lipid profile, renal function, and beta-cell function (HOMA-B) during 12 months were evaluated.ResultsOverall, 594 patients (97% GLP-1RA naïve) were identified (mean age 63.9 ± 9.5 years, 58.7% men, diabetes duration 11.4 ± 8.0 years). After 6 months of treatment with OW semaglutide, HbA1c levels were reduced by 0.90%, FBG by 26 mg/dl, and body weight by 3.43 kg. Systolic blood pressure, total and LDL-cholesterol significantly improved. Benefits were sustained at 12 months. Renal safety was documented. HOMA-B increased from 40.2% to 57.8% after 6 months (p<0.0001).DiscussionThe study highlighted benefits of semaglutide on metabolic control, multiple CV risk factors, and renal safety in the real-world. Semaglutide seems to be an advisable option for preservation of β-cell function and early evidence suggests it might have a role in modifying insulin resistance (HOMA-IR), the pathogenetic basis of prediabetes and T2D.

Efficacy of Regimens in the Treatment of Latent Autoimmune Diabetes in Adults: A Network Meta-analysis

“…GLP-1RAs are relatively emergent hypoglycemic agents that lower blood glucose by activating the GLP-1 receptor. GLP-1 is an enteroglucagon that promotes insulin secretion from pancreatic β-cells in a glucose concentration-dependent manner and inhibits glucagon secretion; it is also able to play a role in delaying gastric emptying and in weight loss [ 13 , 14 , 46 , 47 ]. Few clinical RCTs have been performed on the use of GLP-1RA in the treatment of LADA, and our meta-analysis includes study data on GLP-1RA and the index ΔHbA1c.…”

“…Therapy involving GLP-1 receptor agonists (GLP-1RA) has been shown in a recent study to be more effective in lowering blood glucose in LADA than in T2DM [ 12 ]. A recent study has also shown that semaglutide preserves β-cell function well in the T2DM population [ 13 , 14 ]. Nevertheless, clinical trials have shown that GLP-1RA therapy confers no benefit to participants with T2DM when C-peptide levels are very low or autoantibody titers are very high [ 15 ].…”

Effectiveness and safety of drugs for obesity

“…Most of these studies were aggregated in two reviews published in 2021 7579. Twenty nine additional studies have since been published 8081828384858687888990919293949596979899100101102103104105106107108…”

“…The effect of semaglutide on weight loss has also been evaluated as a secondary outcome in observational studies among patients with type 2 diabetes,9596979899100101102103104105107108 where the primary outcome was HbA 1c . Among studies reporting this outcome, percentage weight reduction ranged from 2.2-7.5% over 9-18 months of follow-up 9596979899100101102103104105106107108. Only one retrospective study has evaluated weight loss as a primary outcome among patients with obesity without type 2 diabetes.…”

“…Among studies reporting this outcome, percentage weight reduction ranged from 2.2-7.5% over 9-18 months of followup. [95][96][97][98][99][100][101][102][103][104][105][106][107][108] Only one retrospective study has evaluated weight loss as a primary outcome among patients with obesity without type 2 diabetes. This study 94 used electronic health record data at one academic health system to evaluate 175 patients with obesity who took semaglutide for ≥3 months.…”