Oral Semaglutide Improves Metabolic Outcomes in Type 2 Diabetes: A Spain-based Study

Carlos Casado; Cardenas Salas Jersy Jair; Sierra Poyatos Roberto Miguel; Alvarez Teresa Montoya; Gonzalez Diego Meneses; Ruiz Sanchez Jorge Gabriel; Luca Bogdana Luiza; Lechuga Begona Sanchez; los Angeles Velez Romero Maria de; Martinez Clotilde Vazquez

doi:10.1530/endoabs.90.P336

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Endocrine Abstracts (2023) 90 P336 | DOI: 10.1530/endoabs.90.P336

ECE2023 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (159 abstracts)

Oral Semaglutide Improves Metabolic Outcomes in Type 2 Diabetes: A Spain-based Study

Carlos Casado ¹ , Jersy Jair Cardenas Salas ^1,2 , Roberto Miguel Sierra Poyatos ^1,3 , Teresa Montoya Alvarez ² , Diego Meneses González ¹ , Jorge Gabriel Ruiz Sánchez ¹ , Bogdana Luiza Luca ¹ , Begoña Sánchez Lechuga ¹ , María de los Angeles Velez Romero ¹ & Clotilde Vazquez Martinez ^1,2,3

Err

Author affiliations

¹Fundación Jiménez Diaz, Endocrinology and Nutrition, Madrid, Spain; ²Hospital Universitario Infanta Elena, Valdemoro, Spain; ³General Hospital Villalba, Collado Villalba, Spain

Objectives: To evaluate the changes in HbA1c, basal glucose, weight, and lipid profile in patients with type 2 diabetes after starting oral semaglutide.

Methods: This study was conducted in Madrid, Fundación Jiménez Díaz, Infanta Elena and General de Villalba hospitals. A total of 75 patients with type 2 diabetes were included. The mean age was 62.0±10.5 years and 60% were men. The mean duration of diabetes was 7.3±6.6 years, and 66.7% had hypertension, 67.6% had dyslipidemia, 14.9% were smokers, 23.0% had sleep apnea, and 26.4% had microvascular disease. Basal treatment included insulin in 12.0%, metformin in 86.7%, SGLT2i in 48%, DPP4i in 41.9%, GLP1-Ra in 1.3%, repaglinide in 8.1%, and Sulphonylurea in 2.7%. A total of 58.3% of patients reached a dose of 7 mg, and 41.7% reached 14 mg. 4 patients discontinued the treatment, 2 due to adverse effects and 2 due to administrative problems. Gastrointestinal adverse effects were reported in 16% of patients. The study had a follow-up period of 7.3±6.6 months. Paired T-Student test for parametric data (α), Wilcoxon test for non-parametric data (β), and McNemar test for proportions (ф) were used for statistical analysis.

Results: The following changes were observed after starting oral semaglutide:


		Comparison
	Basal	6 months	Differences
Basal glucose (mg/dl)^α	165,0±5,9	135,0±5,0	-30,0 (_95%IC: -41,1 a -19,0) **
HbA1c (%) ^α	7,85± 0,16	6,67±0,14	-1.18 (_95%IC: -1,50 a -0.85)**
Weight (kg)^α	95.1±1,5	89,8±1,4	-5,4 (_95%IC: -6.4 a – 4,3)**
BMI (kg/m²)^α	34.5±0,5	32.6±0,5	-1.9 (_95%IC: -2.3 a – 1,6)**
Total Cholesterol (mg/dl)^α	171,7±5,5	153,7±4,3	-18,0 (_95%IC: -27,8 a – 8,2)**
LDL-cholesterol (mg/dl)^α	90,8±4,2	79,0±3,8	-11,8 (_95%IC: -18,5 a – 5,1)**
Triglycerides (mg/dl)^β	159(P_25-75:121-208)	131(P_25-75:102-172)	-24(_95%IC: -38 a -4)**
HbA1c <7%^ф	33,3%	67,1%	+34,2% (_95%IC: 22,6 a 48,6)**
HbA1c reductions by basal HbA1c^α
HbA1c > 7%	-1,3 (_95%IC: -1,7 a -0,8)**
.HbA1c > 8%	-1,6 (_95%IC: -2,0 a -1,2)**
HbA1c > 9%	-1,8 (_95%IC: -2,3 a -1,3)**
** P<0.01; * P<0.05

Conclusions: Oral semaglutide was associated with significant improvements in HbA1c, fasting glucose, weight, and lipid profile in patients with type 2 diabetes. The treatment was well tolerated, with a low incidence of adverse effects. The results of this study support the use of oral semaglutide.