ECE2020 ePoster Presentations Diabetes, Obesity, Metabolism and Nutrition (142 abstracts)
Real world data of Type 2 Diabetes Mellitus (T2DM) obese patients using another GLP1 receptor agonist (GLP1–RA) and switching to Semaglutide in Spain
Jersy Cardenas1, 2, Nancy Sanchez Gomez1, Roberto Miguel Sierra Poyatos1, 3, Bogdana Luiza Luca1, Naiara Modroño Mostoles1, 2, Teresa Montoya Alvarez2, Maria Jesus Silva Rodriguez1, 2, Maite Ortega Juaristi1, Diego Meneses González1, Maria De Los Angeles Gonzalo Redondo1, Alba Galdon Sanz–Pastor1, Jorge Ruiz Sanchez1, María De La Paz Gómez Montes2, Cristina Cruces Vega2 & Clotilde Vazquez Martinez1
1Hospital Universitario Fundacion Jimenez Diaz, Endocrinology, Madrid, Spain; 2Hospital Universitario Infanta Elena, Endocrinology, Madrid, Spain; 3hospital General De Villalba, Endocrinology, Collado Villalba, Spain
Objectives: Semaglutide was approved for the treatment of T2DM patients with a body mass index (BMI) > 30kg/m2 by the Spanish National Health Service in May 2019. We evaluate clinical outcomes of patients on previous treatment with any another GLP1–RA that switch to Semaglutide.
Material and Methods: Retrospective analysis. Sixty–five T2DM patients were included. Demographic data, anthropometric, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), glycated hemoglobin (HbA1c) and body composition data were collected at baseline and after 6 months of switching. Statistical analysis was performed with STATA 14. Paired T–student test for comparison between baseline and 6 months and logistic regression to evaluate Semaglutide dose (≤ 0.5 and 1.0 mg/weekly), age, sex, duration of T2DM, BMI and HbA1c at baseline as possible predictors of Semaglutide efficacy to achieve HbA1c <7%.
Results: Of 65 patients switching to semaglutide (4.6% on 0.25 mg/weekly, 66.15% on 0.5 mg/weekly and 23.07% on 1 mg/weekly), 54.68% were males and the median age was 60.66 ± 9.1 years. Mean duration of T2DM was 12.78 ± 8.2 years. Regarding previous GLP1–RA: 43.0%, 38.5%, 16.9% and 1.5% switch from liraglutide, dulaglutide, exenatide and lysixenatide respectively. Seven patients discontinue treatment because of gastrointestinal intolerance and data of 2 patients were missing, including 56 patients in the final analysis. Waist circumference changed in –2.02 cm (CI95% –3.62 to –0.41) and HbA1C in –0.39% (CI95% –0.74 to –0.05) after switching. There were no changes in other analyzed variables (Table). Semaglutide dose 1.0 mg/weekly (OR: 6.69; CI95% 1.14 to 39.24) and baseline HbA1c (OR 0, 37; CI95% 0.16 to 0.83) were independent predictors to achieve HbA1c <7% after switching to Semaglutide.
| Baseline | Change from Baseline | |||
| 0.5 mg n = 39 | 1.0 mg n = 15 | Total N = 56 | ||
| Weight–(kg) | 98.2 ± 14.84 | –0.88 | –0.62 | –0.58 (–1.71 to 0.54) |
| Waist–(cm) | 116.1 ± 9.4 | –1.93 | –2.33 | –2.25 (–3.67 to –0.84)* |
| SBP–(mmHg) | 133.5 ± 14.17 | –0.30 | +0.77 | –0.40 (–5.37 to 4.56) |
| DBP–(mmHg) | 81.37 ± 11.47 | –0.66 | –3 | –1.45 (–3.78 to 0.89) |
| Fat–(%) | 40.9 ± 8.0 | +0.25(n = 12) | +3.48(n = 6) | –0.57 (–5.57 to 4.42)(n = 18) |
| Lean mass–(kg) | 33.1 ± 7.3 | –1.11(n = 12) | –1.55(n = 6) | –1.09 (–2.84 to 0.67)(n = 18) |
| BMI–(kg/m2) | 35.4 ± 5.0 | –0.26 | –0.18 | –0.17 (–0.55 to 0.21) |
| FG–( mg/dl) | 157.4 ± 55.1 | +8.18 | –9.47 | +3.93 (–13.10 to 20.97) |
| HbA1C–(%) | 7.6 ± 1.2 | –0.18 | –0.99 (–1.93 to –0.03)* | –0.34 (–0.66 to –0.01)* |
| Insulin dose (UI/day) | 50.4 ± 33.6 | –1.86(n = 15) | –3.63(n = 8) | –1.67 (–6.14 to 2.81)(n = 24) |
| *P < 0.05. Two patients (semaglutide 0.25 mg/weekly) are not included in the table. Data in mean ± SD, mean(CI95%) | ||||
Conclusions: Patients with T2DM and obesity using previously GP1RA and switching to semaglutide 1 mg present better glycemic control and less waist circunference.
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