Introduction: The glucagon-like peptide-1 receptor analogue (GLP-1RA) semaglutide is associated with improvements in glycaemia and cardiovascular risk factors in clinical trials. The aim of this study was to examine the real-world impact of semaglutide administered by injection in people with type 2 diabetes (T2D) across three secondary care sites in Wales. Methods: A retrospective evaluation of 189 patients with T2D initiated on semaglutide between January 2019 and June 2020 with at least one follow-up visit was undertaken. Results: At baseline, participants had a mean age of 61.1 years, mean glycated haemoglobin (HbA1c) of 77.8 mmol/mol (9.3%) and mean body weight of 101.8 kg. At 6 and 12 months of follow-up, mean HbA1c reductions of 13.3 mmol/mol (1.2%) and 16.4 mmol/mol (1.5%), respectively, were observed, and mean weight loss at 6 months was 3.0 kg (all p \ 0.001). At 12 months, there were significant reductions in total cholesterol (0.5 mmol/L) and alanine transaminase (4.8 IU/L). Patients naïve to GLP-1RAs or with higher baseline HbA1c at baseline had greater glycaemic reductions, although clinically significant HbA1c reductions were also observed in those who switched from other GLP-1RAs, whose body mass index was \ 35.0 and [ 35.0 kg/m 2 or who had lower baseline HbA1c. Semaglutide was generally well tolerated, although adverse-effects limited use in 18 patients (9.5%). Conclusion: Semaglutide provided clinically and statistically significant reductions in HbA1c, body weight, lipids and liver enzymes.

Since the start of the COVID‐19 pandemic, the vulnerability of people with diabetes has been recognised with a greater risk of morbidity and mortality compared to the general population. The outcomes associated with diabetes may be a consequence of an impaired immune response, presence of composite comorbidities or the multi‐organ infectivity of SARS‐CoV‐2 affecting the pancreas. Emerging evidence suggests that both acute and chronic hyperglycaemia can exacerbate the clinical consequences of COVID‐19. Thus, the role of health care professionals in the observation and management of glucose control is increasingly recognised in people with diabetes in both the acute and chronic setting. In this review, we highlight the key biological implications of SARS‐CoV‐2 infection in people with diabetes, the clinical outcomes of COVID‐19 in people with diabetes and management principles with respect to glucose control including our local experiences. Copyright © 2021 John Wiley & Sons.

Background and aimsWe examined HbA1c and cardiovascular risk factors with a median follow-up of 44 months therapy with dapagliflozin. MethodsWe undertook a clinical practice evaluation of 101 patients attending our clinic. ResultsDapagliflozin resulted in a significant reduction in HbA1c 82.6 ±15.7 v 68.7 ±17.8 mmol/mol. ConclusionDapagliflozin maintains glycaemic control along with sustained improvements in weight and no decline in renal function.1. Dapagliflozin provides effective glycaemic control over a median of 44 months without deterioration in renal function.2. Weight loss was maintained with therapy during the treatment period.3. This supports maintained benefits associated with dapagliflozin during follow-up in routine clinical practice.