Endocrine Abstracts

Introduction: The long acting GLP-1 analogue, Semaglutide (S), is indicated for the treatment of adults with type 2 diabetes mellitus (T2DM). Since November 2021, S has also been approved by the European Medicines Agency (EMA) at a dose of 2.4 mg for the treatment of obesity. Here, we report the efficacy of S, either alone or in combination with other antidiabetic drugs, in patients with T2DM and obesity on glycated hemoglobin (HBA1C) and weight loss.

Patients and Methods: We retrospectively evaluated 129 patients (75 F and 54 M; mean age 61.2±9.8 years) with T2DM and obesity treated with S for glycemic control and for weight loss. At the first visit, mean weight was 101.8±24.6 kg and mean body mass index (BMI) was 36.7±8.7 kg/m². At baseline mean HBA1C was 7.7±1.5%. S was administered as monotherapy or in combination with metformin. S was administered once-weekly subcutaneously at starting dose of 0.25 mg and with monthly increases up to 1.0 mg. The aim of this study was to evaluate the efficacy of S on HBA1C and according to the weight loss reduction more than (>) 5% or >10% in this setting of patients.

Results: After 6-month follow up, 115/129 patients had a mean weight of 95.2±24.3 kg and mean BMI of 34.3±9.4 kg/m², with a mean percentage weight reduction of -9.5±6.5% and mean BMI reduction of -3.7±3.1 kg/m². After 6-month of therapy HBA1C was 6.4±0.9%, with a mean reduction of -1.8±1.5%. In 55.4% of patients that lost >5% of weight, mean HBA1C reduction was -1.6±1.2%, while in 44.6% patients that lost >10% of weight from baseline, there was a mean HBA1C reduction of -2.1±1.7%. After 12-month follow up, 47/129 patients had a mean weight of 88.9±17.9 kg and mean BMI of 31.9±5.6 kg/m² with a mean percentage weight loss of -9.2±7.6% and mean BMI reduction of -3.3±2.8 kg/m². After 12-month follow up mean HBA1C was 6.4±0.9%, with a mean reduction of -1.6±1.6%. In 42.6% of patients with a weight loss >5%, there was a mean HBA1C reduction of -1.4±1.6%. In 57.4% of patients with a weight loss >10%, mean HBA1C reduction was -1.7±1.5% from baseline. S was well tolerated and no patient experienced serious adverse events.

Conclusions: Our results confirm the efficacy and safety in glycometabolic control of S therapy in patients with T2DM and obesity. In our study S provide significant weight loss and reduction in HBA1C, probably further reduced also due to the significant weight loss.