Del Prete Michela, Gavazzi Lidia, Disoteo Olga Eugenia, Vignati Federico, Di Sacco Gianleone, Muratori Fabrizio
Division of Endocrinology, Diabetology and Clinical Nutrition, Sant'Anna Hospital - ASST Lariana, Como, Italy.
Eat Weight Disord. 2025 Jan 9;30(1):2. doi: 10.1007/s40519-024-01711-2.
To report data on the real-world effectiveness and safety of injectable (IS) and oral (OS) therapies in obese or overweight diabetes (T2DM) patients on glycometabolic control, weight loss (WL) and weight maintenance after the use of semaglutide.
175 subjects with obesity or overweight and T2DM were retrospectively assessed. Of these, 129 (75F, 54 M; mean age 61.2 ± 9.8 years) patients were treated with IS and 46 (24F, 22 M; mean age 65.7 ± 12.8 years) with OS for T2DM and WL. At baseline, mean weight (mW) was 101.8 ± 24.6 kg and 95.2 ± 15.0 kg; mean body mass index (mBMI) was 36.7 ± 8.7 kg/m and 34.3 ± 5.3 kg/m.
After 6 months, in the IS group, 127 patients had a mW and mBMI reduction of - 10.4 ± 8.1 kg and - 3.9 ± 3.0 kg/m. 46 patients in the OS group had a mW and mBMI reduction of - 6.7 ± 5.3 kg and - 2.6 ± 2.1 kg/m. After 12 months, 102 patients in the IS group achieved a mW and mBMI reduction of - 9.3 ± 7.5 kg and - 3.4 ± 2.6 kg/m. 44 patients in the OS group of treatment had a mW and mBMI reduction of - 10.7 ± 6.5 kg and - 3.9 ± 2.4 kg/m. After 24 months, 92 patients in the IS group of therapy achieved a mW and mBMI reduction of - 15.9 ± 11.4 kg and - 5.8 ± 3.7 kg/m. There was a mean percentage reduction of glycated hemoglobin (HBA1C) of - 1.9 ± 1.4%, - 1.5 ± 1.9%, and - 1.5 ± 1.7% after 6, 12 and 24 months in the IS group. In the OS group there was a mean reduction of - 1.5 ± 1.6% after 6 months and of - 0.8 ± 0.6% after 12 months of therapy.
Semaglutide induces WL maintenance after 12 and 24 months of treatment. Our results show a comparable effectiveness of IS and OS in T2DM patients with obesity or overweight. IS and OS treatment provide significant WL that allows reaching the glycometabolic therapeutic goal in a short time. Level of Evidence Level II.
报告注射用（IS）和口服（OS）疗法在肥胖或超重糖尿病（T2DM）患者中对糖代谢控制、体重减轻（WL）及使用司美格鲁肽后体重维持情况的真实世界有效性和安全性数据。
对175例肥胖或超重且患有T2DM的受试者进行回顾性评估。其中，129例（75例女性，54例男性；平均年龄61.2±9.8岁）患者接受IS治疗，46例（24例女性，22例男性；平均年龄65.7±12.8岁）患者接受OS治疗以控制T2DM和减轻体重。基线时，平均体重（mW）分别为101.8±24.6千克和95.2±15.0千克；平均体重指数（mBMI）分别为36.7±8.7千克/米²和34.3±5.3千克/米²。
6个月后，IS组中127例患者的mW和mBMI分别降低了-10.4±8.1千克和-3.9±3.0千克/米²。OS组中46例患者的mW和mBMI分别降低了-6.7±5.3千克和-2.6±2.1千克/米²。12个月后，IS组中102例患者的mW和mBMI分别降低了-9.3±7.5千克和-3.4±2.6千克/米²。OS组中44例接受治疗的患者的mW和mBMI分别降低了-10.7±6.5千克和-3.9±2.4千克/米²。24个月后，IS组中92例接受治疗的患者的mW和mBMI分别降低了-15.9±11.4千克和-5.8±3.7千克/米²。IS组在6、12和24个月后糖化血红蛋白（HBA1C）的平均降低百分比分别为-1.9±1.4%、-1.5±1.9%和-1.5±1.7%。OS组在治疗6个月后平均降低了-1.5±1.6%，在治疗12个月后降低了-0.8±0.6%。
司美格鲁肽在治疗12个月和24个月后可维持体重减轻。我们的结果表明，IS和OS在肥胖或超重的T2DM患者中具有相当的有效性。IS和OS治疗可显著减轻体重，使患者在短时间内达到糖代谢治疗目标。证据级别：二级。
