Endocrine Abstracts

Background: Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1-RA) whose role as a second-line treatment for patients with type 2 diabetes (T2D) has significantly increased. It has demonstrated cardiovascular safety and superiority in terms of glycaemic control and weight loss, compared to other GLP-1-RAs. The most common side effects are mild gastrointestinal, but it may also cause renal failure secondary to dehydration and an increased risk of diabetic retinopathy (DR) complications may be observed in patients with pre-existing DR.

Objectives: To evaluate the effects of short-term treatment with semaglutide, including changes in weight, blood pressure, fasting glucose, HbA1c, LDL-cholesterol, triglycerides and renal function; its safety regarding side effects; and the potential role of semaglutide in the overall improvement of patients with T2D.

Methods: A follow-up study of 38 patients with T2D and obesity (body mass index-BMI > 30 Kg/m²) who started treatment with once-weekly injectable semaglutide in our centre. Data were obtained from the medical records and analysed with SPSS v25.

Results: The mean age of patients was 59.89 ± 9.96 years; 50% were women. Mean T2D disease duration was 14.23 ± 12.39 years, mean HbA1c was 8.27 ± 1.61%, mean BMI was 38 ± 5.7 kg/m² and 36.8% of patients had been on a previous GLP-1-RA. Significant improvement were observed at the first follow-up visit after starting semaglutide (79.74 ± 41.3 days) in weight (104.77 vs 108.38 kg; P < 0.001), BMI (36.7 vs 38.03 kg/m²; P < 0.001), fasting glucose (139.13 vs 171.76 mg/dl; P = 0.023) and HbA1c (7.54 vs 8.27%; P = 0.002). The potential benefit was higher with optimal/increased doses of semaglutide. A non-significant improvement in LDL-cholesterol and triglycerides was noted. Patients previously treated with another GLP-1-RA experienced no significant changes. However, in patients previously treated with oral antidiabetic drugs (OAD) there were significant improvements in weight (–4.2 kg, P < 0.001) and HbA1c (–2.95%, P = 0.003). Regarding therapeutic optimization, we observed a reduction in the required dose of basal insulin (42 vs 46 units; P = 0.05) in prior insulin users. Adverse events were mild in severity, occurred mainly during the first days/weeks (88.89%), and only two cases required treatment discontinuation.

Conclusions: Semaglutide resulted in significant reductions in HbA1c, fasting blood glucose and body weight during short-term treatment. In addition, adverse events were uncommon. Long-term treatment studies in larger sample populations are required for a better evaluation of this new GLP-1-RA.