Dutta Aditya, Mahendru Shama, Sharma Rutuja, Mithal Ambrish
Department of Endocrinology, Max Super Speciality Hospital, Saket, New Delhi, India.
Indian J Endocrinol Metab. 2024 Nov-Dec;28(6):653-658. doi: 10.4103/ijem.ijem_266_24. Epub 2024 Dec 30.
Oral Semaglutide (Sema-o) is the first oral glucagon like peptide-1 receptor analogue (GLP-1RA) commercially available for the treatment of type 2 diabetes (T2D). This study aimed to evaluate the efficacy of Sema-o in patients with T2D when added to the existing therapy.
This retrospective real-world study enrolled adult patients with diabetes taking Sema-o, with at least one follow-up (from February 2022 till October 2023). A proforma recorded baseline and follow-up date, medications, body composition, laboratory and clinical parameters. Data is presented as median (interquartile range) and was analysed using SPSS.
A total of 351 patients followed up once, while 56 patients had 4 follow-up visits. Baseline parameters were as follows: age 53 years (43-61), duration of diabetes 10 years (5-16), weight 91 kg (79-103), body mass index (BMI) 32.7 kg/m (29.3-36.6) and HbA1c 7.9% (6.9-9). The addition of Sema-o in the existing therapy for diabetes resulted in a significant reduction in HbA1c {follow-up: 1 0.5%, 2 0.9%, 3 1.1% and 4 1.1% (all, < 0.001)} and % weight reduction {follow-up: 1 2%, 2 3.3%, 3 4.1% and 4 4.3% (all, < 0.001)} from baseline. Reductions in BMI, glucose (fasting/post-prandial), lipids, liver enzymes and body composition parameters were significant. Gastro-intestinal side-effects (299 events in 52.4% of patients) were frequent. A total of 34/9.7% patients discontinued Sema-o.
Intensification of existing therapy with Sema-o in obese patients with moderately uncontrolled diabetes proved to be an effective and relatively safe strategy. Achieving normoglycemia and reductions in weight, lipids and body fat/visceral fat with Sema-o may confer a much needed cardiometabolic benefit in these patients.
口服司美格鲁肽（Sema-o）是首个可用于治疗2型糖尿病（T2D）的商业化口服胰高血糖素样肽-1受体激动剂（GLP-1RA）。本研究旨在评估Sema-o添加到现有治疗方案中对T2D患者的疗效。
这项回顾性真实世界研究纳入了服用Sema-o的成年糖尿病患者，且至少有一次随访（从2022年2月至2023年10月）。一份表格记录了基线和随访日期、用药情况、身体成分、实验室及临床参数。数据以中位数（四分位间距）表示，并使用SPSS进行分析。
共有351例患者接受了一次随访，56例患者接受了4次随访。基线参数如下：年龄53岁（43 - 61岁），糖尿病病程10年（5 - 16年），体重91千克（79 - 103千克），体重指数（BMI）32.7千克/米²（29.3 - 36.6），糖化血红蛋白（HbA1c）7.9%（6.9 - 9）。在现有糖尿病治疗方案中添加Sema-o可使HbA1c从基线水平显著降低{随访1次时降低0.5%，2次时降低0.9%，3次时降低1.1%，4次时降低1.1%（所有P均<0.001）}，体重降低百分比{随访1次时降低2%，2次时降低3.3%，3次时降低4.1%，4次时降低4.3%（所有P均<0.001）}。BMI、血糖（空腹/餐后）、血脂、肝酶及身体成分参数均有显著降低。胃肠道副作用较为常见（52.4%的患者出现299起事件）。共有34例/9.7%的患者停用了Sema-o。
在肥胖且糖尿病控制不佳的患者中，用Sema-o强化现有治疗方案被证明是一种有效且相对安全的策略。使用Sema-o实现血糖正常化以及体重、血脂和体脂/内脏脂肪的降低，可能会给这些患者带来急需的心脏代谢益处。
