In patients with type 2 diabetes inadequately managed on diet and exercise (with or without metformin), daily subcutaneous semaglutide significantly improved glycaemic control and promoted weight loss compared to both liraglutide and placebo, though it was associated with higher gastrointestinal side effects.
PICO Summary
Population:
Adults with type 2 diabetes poorly controlled on diet and exercise, optionally using metformin, with HbA1c levels between 7.0% and 10.0%.
Intervention:
Once-daily subcutaneous semaglutide (0.05–0.3 mg).
Comparison:
Once-daily liraglutide (0.3–1.8 mg) and placebo.
Outcome:
- Efficacy: Semaglutide achieved significantly greater HbA1c reduction and weight loss than liraglutide at comparable doses (p < 0.001).
- Safety and Tolerability: Gastrointestinal side effects were more frequent with semaglutide, especially at higher doses.
Clinical Summary
Main Finding:
Semaglutide daily led to more substantial HbA1c reduction and weight loss than liraglutide and placebo, but with an increased risk of gastrointestinal side effects.
Clinical Relevance:
These findings support semaglutide as a potent daily option for glycaemic control and weight loss in type 2 diabetes, although tolerability, especially gastrointestinal, needs consideration.
Study Overview:
- Type of Study: 26-week, multicentre, randomised, double-blind trial.
- Sample Size & Population: 705 patients with type 2 diabetes on diet/exercise regimens.
- Intervention Duration & Doses: 26 weeks, daily semaglutide (0.05–0.3 mg).
- Comparison: Liraglutide (0.3–1.8 mg) and placebo.
Outcomes:
- Primary Measure (HbA1c): Semaglutide reduced HbA1c more significantly than liraglutide at all matched dose levels.
- Secondary Measure (Body Weight): Weight reduction was dose-dependent with semaglutide, exceeding reductions seen with liraglutide.
- Safety Profile: Gastrointestinal side effects were more common in semaglutide groups, with a dose-response relationship.
Considerations:
Higher gastrointestinal side effects with semaglutide may impact tolerability. Extended trials would clarify long-term effects, especially at higher doses.
Reference:
Lingvay, I., Desouza, C. V., Lalic, K. S., et al. (2018). Diabetes Care, 41(9), 1926–1937. doi:10.2337/dc17-2381.
