Endocrine Abstracts

Introduction

Semaglutide is a glucagon-like peptide-1 receptor agonist which has shown important benefits in patients with type 2 diabetes mellitus (T2DM) in randomized clinical trials. Its commercialization in Spain began in May of 2019. The main purpose of this study was to analyze the effectiveness of this drug into routine clinical practice in patients with T2DM with a body-mass index above 30 kg/m².

Matherial and methods

Retrospective observational study including demographic, analytical and clinical features of 27 patients in whom semaglutide was started. The beginning dose was 0.25 mg once-weekly during the first month, and after this period of time it was increased to 0.5 mg once-weekly. A second follow-up visit was performed 6 months after the drug was started, with the aim of evaluating the impact of its use.

Results

Data of 27 patients (14 men and 13 women) with TD2M were analyzed. The overall mean age was 60.1 ± 11 years, with a mean time of evolution of the disease of 8.7 ± 6.5 years. The 18.5% of them had established cardiovascular disease (coronary heart disease). Basal characteristics of the population at the beginning: BMI 42.3 ± 8.3 kg/m²; weight 116.8 ± 30.3 kg; HbAa1c 8.2 ± 1.6%; fasting blood glucose 166.7 ± 55.6 mg/dl; blood pressure 149.5 ± 22.2/84.8 ± 12.6 mm Hg. The number of antidiabetic drugs was 1.44 ± 0.75 before starting semgalutide (85% of the patients were receiving metformin, 26% SGLT-2 inhibitors, 26% GLP-1 RA, 11% sulfonylurea and 7% DPP-4 inhibitors). 37% of the patients were treated with insulin therapy. At six-months follow-up visit, significant mean reductions of BMI (39.9 ± 7.1 kg/m²), weight (110.7 ± 25.9 kg), HbA1c (6.6 ± 1.1%) and fasting blood glucose (116.4 ± 24.9 mg/dl) were obtained. After this, 85% of the patients treated with metformine and 48% with SGLT-2 inhibitors. Sulfonilureas were discontinued in all patients. The DPP4 inhibitors were discontinued when semaglutide was started. The percentage of patients with insulin therapy did not change.

Conclusions

Semaglutide is an effective pharmacologic agent for the treatment of T2DM in terms of metabolic control (HbA1c reduction) and weight reduction.