Endocrine Abstracts

Background: Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) which is widely used for the management of type 2 diabetes as well as for the obesity treatment. Evidence suggest that the level of HbA1c reduction and weight loss with oral semaglutide were similar to those of the subcutaneous formulation¹. However, oral formulation not only improves the patient’s compliance to treatment but also makes it a favourable option for those who are reluctant to use an injectable agent. The aim of this audit is to evaluate the effect of oral Semaglutide on mean reduction of HbA1c and weight following mean duration of treatment of 6 months.

Materials and Methods: A comprehensive retrospective review of patient’s clinical and laboratory database was conducted for 36 patients (22 males / 14 females, mean age 58±20 years, duration of diabetes 20 years or less) in our region in County Durham Darlington, United Kingdom during the period between September 2020 - March 2022. The starting dose of oral Semaglutide was 3mg for the first month, 7 mg during the second month and then increased to 14 mg from third month onwards. The effect of this drug on mean reduction in HbA1c and weight was measured following mean duration of 6 months of treatment.

Results: At baseline, mean HbA1c was 75.3±19 mmol/mol and mean weight was 97.4±27 kg among the audited 36 patients. The mean duration of treatment was 6.2 months (95% CI=3, 14 months). Following 6.2 months of treatment, mean HbA1c was 67.7±17 mmol/mol and mean weight was 94.9±26 kg. Hence, mean HbA1c reduction was 7.5 mmol/mol (95% CI=-44, 41 mmol/mol) and mean weight reduction was 2.53 kg (95% CI=-9.2, 3.14 kg). The p-value was 0.01.

Conclusion: To conclude, we can say that, oral Semaglutide is an effective pharmacological agent in reducing both HbA1c and weight. However, our observations need to be confirmed in larger cohorts and for extended period of treatment.

Reference: 1. Hedrington MS, Davis SN. Oral semaglutide for the treatment of type 2 diabetes. Expert opinion on pharmacotherapy. 2019 Jan 22;20(2):133-41.