Summary: In overweight or obese adults with type 2 diabetes (T2DM) and non-alcoholic fatty liver disease (NAFLD), combination therapy of semaglutide (GLP-1 receptor agonist) and empagliflozin (SGLT-2 inhibitor) administered over 52 weeks significantly improved liver fat reduction (as assessed by controlled attenuation parameter), liver enzyme levels, blood glucose control, and lipid profiles compared to monotherapy using either semaglutide or empagliflozin individually for the same duration, with safety and tolerability analyses supporting the use of the combination treatment. PICO Description Population Overweight or obese adults with type 2 diabetes (T2DM) and non-alcoholic fatty liver disease (NAFLD). Intervention Combination therapy of semaglutide…
Author: FWA
Summary: In adults aged 18 years or older with obesity-related heart failure with preserved ejection fraction (HFpEF), characterized by a BMI ≥30 kg/m², left ventricular ejection fraction ≥45%, and New York Heart Association class II-IV symptoms, semaglutide 2.4 mg administered once weekly for 52 weeks significantly improved heart failure symptoms (mean KCCQ-CSS score increase of 7.5 points, 95% CI 5.3 to 9.8, p<0.0001) and reduced body weight by 8.4% (95% CI -9.2 to -7.5, p<0.0001) compared to matched placebo administered once weekly under identical conditions. Additional benefits included improved 6-minute walk distance (+17.1 meters, p<0.0001), reduced C-reactive protein (treatment ratio…
Summary: In patients with heart failure with preserved ejection fraction, obesity (BMI ≥30), and type 2 diabetes, once-weekly semaglutide (2.4 mg) injection for 52 weeks significantly improved heart failure-related symptoms and physical limitations (mean difference: 7.3 points, P<0.001) and resulted in greater weight loss (-6.4%, P<0.001) compared to placebo injections administered once weekly, though it was associated with fewer serious adverse events reported in the semaglutide group (17.7% vs. 28.8%). PICO Description Population Patients with heart failure with preserved ejection fraction, obesity (BMI ≥30), and type 2 diabetes. Total participants: 616. Intervention Once-weekly semaglutide (2.4 mg) injection for 52 weeks.…
Summary: In adults with long-standing type 2 diabetes inadequately controlled, subcutaneous tirzepatide, a dual agonist of GIP and GLP-1 receptors significantly enhanced pancreatic islet function, improved insulin sensitivity, and facilitated substantial reductions in blood glucose, aiding many patients in achieving normoglycemia compared to placebo and semaglutide interventions. PICO Description Population Adults with long-standing type 2 diabetes inadequately controlled, characterized by an inability to achieve normoglycemia through existing treatments. Intervention Subcutaneous tirzepatide, a dual agonist of GIP and GLP-1 receptors, administered as part of a phase 1, randomized, double-blind trial. Comparison Placebo and semaglutide interventions to evaluate the efficacy and physiological…
A clinical guideline update on the prevention or delay of diabetes and associated comorbidities was published in January 2025 by the American Diabetes Association (ADA) Professional Practice Committee. These guidelines, published in Diabetes Care (2025;48(Suppl. 1):S50–S58).
In patients with uncontrolled type 2 diabetes on metformin, once-weekly semaglutide 1.0 mg and once-daily canagliflozin 300 mg significantly improved body composition metrics such as fat and lean mass reduction. While semaglutide demonstrated a numerically greater reduction in fat mass than canagliflozin, the difference was not statistically significant. Both treatments were well tolerated, though gastrointestinal side effects were a notable concern with semaglutide. PICO Summary Population: Adults aged ≥18 with type 2 diabetes, HbA1c 7.0%-10.5%, on stable metformin doses (≥1500 mg or maximum tolerated dose) with eGFR ≥60 mL/min/1.73 m². Exclusions included history of pancreatitis or severe cardiovascular events. Intervention:…
In patients with type 2 diabetes treated with metformin and basal insulin, once-weekly semaglutide significantly improved glycaemic control (HbA1c reduction) and body weight compared to thrice-daily insulin aspart, though it was associated with higher rates of gastrointestinal side effects. PICO Summary Population: Adults with type 2 diabetes inadequately controlled with basal insulin (glargine) and metformin, HbA1c between 7.5%-10.0%. Intervention: Once-weekly semaglutide (1.0 mg subcutaneously). Comparison: Thrice-daily insulin aspart (dose adjusted based on self-monitored glucose profiles). Outcome: Efficacy: Semaglutide achieved greater HbA1c reduction (mean decrease of 1.5%) compared to insulin aspart (1.2%), with significant weight loss (-4.1 kg vs. +2.8 kg;…
In adults with type 2 diabetes inadequately controlled with metformin, semaglutide 1.0 mg once weekly significantly reduced HbA1c and body weight compared to daily canagliflozin 300 mg, though semaglutide was associated with higher rates of gastrointestinal side effects. PICO Summary Population: Adults (n=788) aged ≥18 years with type 2 diabetes, HbA1c levels 7.0–10.5%, BMI ≥25, on stable metformin for ≥90 days. Intervention: Semaglutide 1.0 mg, subcutaneous injection once weekly. Comparison: Canagliflozin 300 mg, oral administration once daily. Outcome: Efficacy: • HbA1c reduction: Semaglutide (-1.5%) vs Canagliflozin (-1.0%), ETD -0.49% (p<0.0001). • Weight loss: Semaglutide (-5.3 kg) vs Canagliflozin (-4.2 kg),…
In patients with heart failure with preserved ejection fraction (HFpEF) and obesity, tirzepatide significantly reduced the composite risk of cardiovascular death or worsening heart failure and improved health status compared to placebo, though it was associated with higher gastrointestinal side effects.
In patients with type 2 diabetes, intensive blood-pressure control (targeting systolic BP <120 mm Hg) significantly reduced cardiovascular events compared to standard treatment (systolic BP <140 mm Hg), though it was associated with increased risks of symptomatic hypotension and hyperkalemia.