In patients with type 2 diabetes, once-weekly semaglutide significantly improved glycaemic control (HbA1c reduction) and reduced body weight in a dose-dependent manner compared to placebo, with efficacy at the highest doses surpassing that of daily liraglutide, though it was associated with gastrointestinal side effects.
PICO Summary
Population:
Adults with type 2 diabetes (n = 415), on diet and exercise or metformin, HbA1c of 7.0-10.0%, and weight between 60-110 kg.
Intervention:
Subcutaneous semaglutide (0.1–1.6 mg) administered weekly, with and without dose escalation.
Comparison:
Placebo (weekly) and open-label liraglutide (1.2 or 1.8 mg daily).
Outcome:
- Efficacy: At 12 weeks, semaglutide reduced HbA1c by up to 1.7% and body weight by up to 4.8 kg, significantly outperforming placebo and liraglutide.
- Safety and Tolerability: Gastrointestinal adverse events, including nausea and vomiting, were common, with higher rates at increased doses; no major hypoglycemia or injection site issues were noted.
Clinical Summary
Main Finding:
Semaglutide significantly lowered HbA1c and body weight in patients with type 2 diabetes over a 12-week period.
Clinical Relevance:
This study demonstrates the potential of once-weekly semaglutide as a viable option for glycaemic and weight control in type 2 diabetes, particularly for patients who prefer a non-daily regimen. Dose escalation may mitigate some gastrointestinal side effects, enhancing tolerability.
Study Overview:
- Type of Study: Phase 2, randomised, double-blind, dose-finding trial.
- Sample Size & Population: 415 adults with type 2 diabetes.
- Intervention Duration & Doses: 12-week treatment with semaglutide doses (0.1-1.6 mg), with and without escalation.
- Comparison: Placebo and daily liraglutide (1.2 and 1.8 mg).
Outcomes:
- Primary Measure (HbA1c): Semaglutide achieved up to a 1.7% reduction in HbA1c, superior to placebo and liraglutide.
- Secondary Measure (Body Weight): Weight loss up to 4.8 kg observed with semaglutide, outperforming liraglutide and placebo.
- Safety Profile: Common gastrointestinal events (nausea, vomiting) with dose-dependent discontinuations; no severe hypoglycemia or significant injection site reactions.
Considerations:
Although effective, the frequency of gastrointestinal side effects could limit broader use. Additional studies should assess long-term safety and optimal dosing.
Reference:
Nauck, M. A., et al. (2016). Diabetes Care, 39(2): 231–241. doi:10.2337/dc15-0165
Disclosure: This article on Hormone Insight was created with both human and AI assistance. The human expert editor reviewed the article before publication to ensure accuracy, quality, and clarity.
