Endocrine Abstracts

Introduction: Oral semaglutide has been available in the Spanish market since November 2021. This new formulation has broken the self-injection barrier, and may enhance patient satisfaction.

Methods: Retrospective review of the patients′ records and presential or telephonic interviews. All patients expressed their consent for the anonymous processing of their data. Numeric data are given as mean + s.d; paired t-test was used for comparison. Satisfaction was categorically expressed as very poor, poor, fair, good or very good.

Results: 36 obese patients with type 2 diabetes who had taken at least one pill of oral semaglutide were included. Their age was 56 + 12 years; 58% were female; diabetes duration was 6 + 2 years. Of them 34 remain on treatment, 1 withdrew due to gastric intolerance and 1 due to difficulty to schedule the medication intake. 9 are still on the lowest dose (3 mg/day), 11 on the medium dose (7 mg/day) and 14 on the full dose (14 mg/day), 5 of which started on this dose because they were transferred from previous parenteral GLP-1RA therapy. 24 patients have a HbA1C measurement after at least 2 months on oral semaglutide and the difference with the previous is -1.2 + 0.5%. (P=0.013). 26 patients have a weight measurement after at least 2 months and the difference is -3.2 + 1.3 kg (P=0.032). Mild gastrointestinal disturbances were reported by 8 of the patients (22%), and only persist in 3 of them (8%) but in one case epigastric pain, nausea and vomiting caused withdrawal. No severe hypoglycemia has been reported. Five patients were on previous levothyroxine treatment and their dose was maintained but the intake hour was rescheduled; no dosing changes have been required so far. Seven of the patients were diagnosed with non-proliferative diabetic retinopathy but none were in active treatment; no worsening has been reported. One patient (3%) reported very poor satisfaction, 1 (3%) poor, 4 (11%) fair, 11 (31%) good and 19 (53%) very good. All 5 patients who were transferred from parenteral GLP-1AR reported very good satisfaction.

Conclsions: Our initial experience with oral semaglutide is quite satisfactory, with the expected gastrointestinal disturbances which were mild and non-persistent in the large majority of the patients. No additional clinical problems emerged. Glycemic control was significantly improved without serious hypoglycemia, and body weight was significantly decreased. Satisfaction was good or very good in 5 out of 6 patients.