Efficacy and safety of semaglutide in glycemic control, body weight management, lipid profiles and other biomarkers among obese type 2 diabetes patients initiated or switched to semaglutide from other GLP-1 receptor agonists

Abstract

Purpose Evidence of the efficacy and safety of semaglutide among patients with type 2 diabetes who were initiated on or were switched to semaglutide from other GLP-1 RAs remains limited. The objective of this study was to investigate the short-term effects of switching to semaglutide from other GLP-1 RAs. Methods This retrospective cohort study evaluated patients with type 2 diabetes who were initiated on or were switched to semaglutide due to poor diabetes control with other GLP-1 RAs or other medications, or obesity. HbA1c, body weight, serum creatinine, serum uric acid, parameters of lipid metabolism, and parameters of liver function were measured before and 6 months after administration of semaglutide. Results A total of 50 patients were registered in the study. After switching to semaglutide (n = 43), HbA1c and body weight significantly decreased (p < 0.01, p < 0.01), respectively. The same findings were observed in semaglutide-naïve patients (p = 0.04, p < 0.02) (n = 7). Serum uric acid, total cholesterol, triglycerides, and urinary albumin-creatinine ratio decreased significantly as well (p = 0.04, p = 0.04, p = 0.02, p = 0.04), whereas serum creatinine did not change significantly (p = 0.51). Conclusions Semaglutide showed excellent efficacy, even in patients switched from other GLP-1 RAs. Semaglutide appears to be a promising agent for blood glucose and body weight control in obese type 2 diabetes mellitus patients and could be more potent in treating type 2 diabetes than existing GLP-1 RAs.

Effectiveness and Tolerability of Once-Weekly GLP-1 Receptor Agonists in Clinical Practice: A Focus on Switching Between Once-Weekly Molecules in Type 2 Diabetes

“…Indeed, exposure-response modeling suggests that switching to OW semaglutide from OW exenatide, dulaglutide, or liraglutide allows to achieve further reductions in HbA1c and body weight (7). This would be consistent with the few available real-world observations on switching to semaglutide from other GLP-1RAs (8,(55)(56)(57). In our study, one-third of the patients were previously treated with another GLP-1RAs (switchers).…”

Case Report: Semaglutide-associated depression: a report of two cases

“…GLP-1 is a hormone that inhibits glucagon secretion and promotes insulin secretion ( 17 ). GLP-1 RAs have been shown good promise in the treatment of type 2 diabetes and can also induce weight loss, which is thought to be related to its peripheral effect of delaying gastric emptying and its central anorexigenic effects ( 4 , 18 ). As a long acting GLP-1 RA, semaglutide can translocate to the brain stem, lateral septum (LS), and hypothalamus, interact directly with various GLP-1 receptor subtypes and modulate the activity of neural pathways involved in food intake, reward, and energy expenditure ( 19 , 20 ).…”

Impact of Semaglutide on Glycemic Control and Post-Prandial Glucose Reduction in Patients With Type 2 Diabetes Mellitus

“…; ARODA V.R., 2020). Combining insulin with a 7 or 14 mg oral placebo or semaglutide resulted in a 0.1%, 0.9%, and 1.3% reduction, respectively, in HbA1c levels after 26 weeks (OKAMOTO A. et al, 2021). A reduction in HbA1c was also observed in individuals with T2DM not controlled by insulin or metformin after the use of semaglutide (WRIGHT E.E.J; ARODA V.R., 2020; ZHONG P. et al, 2021).…”

“…Regarding the semaglutide mechanisms that impact the reduction of postprandial glycemia, it is considered that the delay of gastric emptying is more important than the release of insulin in controlling this postprandial state (OKAMOTO A. et al, 2021). This happens because the reduction in the speed of gastric emptying results in a more prolonged absorption (DAHL K. et al, 2021).…”