Baldassarre Maria Pompea Antonia, Di Dalmazi Giulia, Coluzzi Sara, Carrieri Federica, Febo Fabrizio, Centorame Giorgia, Cassino Piergiuseppe, Piacentino Luigi, Baroni Marco Giorgio, Consoli Agostino, Formoso Gloria
Department of Medicine and Aging Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.
Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.
J Clin Med. 2024 May 23;13(11):3054. doi: 10.3390/jcm13113054.
: Semaglutide is the unique once-daily oral glucagon-like receptor agonist presently available. Aims of this study were to describe clinical characteristics of patients with type 2 diabetes (T2D) initiating oral semaglutide, to assess its effects on glycemic control, body weight (BW) and its tolerability in routine clinical practice. : Electronic medical records from two Italian diabetes clinics were evaluated. Mean glycated hemoglobin (HbA1c) and BW were assessed in adults with T2D before and 6 months after oral semaglutide prescription. Treatment discontinuation and safety data were reported. : A total of 192 patients initiating oral semaglutide (44% female) presented a mean age of 66 years, a diabetes duration of 10 years, HbA1c of 7.9% and a BW of 82.6 kg. Almost 50% of patients were obese. Mean HbA1c and BW changes from baseline to follow up were -0.7% and -2.6 kg, respectively. Greater HbA1c reduction was observed in patients with baseline HbA1c ≥ 8% and with diabetes duration <5 years. The composite endpoint of HbA1c ≤7% and a weight loss ≥5% was achieved in 22.5% of the participants. A total of 40 patients (20.8%) discontinued treatment: 26 because of gastrointestinal adverse events, and 10 due to limited effectiveness in lowering HbA1c and/or BW. In a real clinical setting, patients initiating oral semaglutide showed suboptimal metabolic control, short diabetes duration and obesity; a significant improvement in HbA1c and BW was achieved mainly in patients with a more recent diabetes diagnosis, supporting the use of oral semaglutide in the early phase of the disease.
司美格鲁肽是目前唯一可用的每日一次口服胰高血糖素样肽受体激动剂。本研究的目的是描述开始口服司美格鲁肽的2型糖尿病（T2D）患者的临床特征，评估其在常规临床实践中对血糖控制、体重（BW）的影响及其耐受性。：对来自两家意大利糖尿病诊所的电子病历进行了评估。在口服司美格鲁肽处方前及处方后6个月，对成年T2D患者的平均糖化血红蛋白（HbA1c）和体重进行了评估。报告了治疗中断情况和安全性数据。：共有192例开始口服司美格鲁肽的患者（44%为女性），平均年龄66岁，糖尿病病程10年，HbA1c为7.9%，体重82.6kg。近50%的患者肥胖。从基线到随访，平均HbA1c和体重变化分别为-0.7%和-2.6kg。基线HbA1c≥8%且糖尿病病程<5年的患者HbA1c降低幅度更大。22.5%的参与者实现了HbA1c≤7%且体重减轻≥5%的复合终点。共有40例患者（20.8%）停止治疗：26例因胃肠道不良事件，10例因降低HbA1c和/或体重的效果有限。在实际临床环境中，开始口服司美格鲁肽的患者代谢控制欠佳，糖尿病病程短且肥胖；主要在糖尿病诊断较新的患者中，HbA1c和体重有显著改善，支持在疾病早期使用口服司美格鲁肽。
