High dose of oral semaglutide may improve blood sugar control: study

Diabetes is a chronic condition that affects the ability to control blood sugar levels. For many patients, the condition worsens over time, making it more difficult to control blood sugar levels. Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, have given patients greater control over blood glucose regulation.

John Buse, MD, PhD, Verne S. Caviness Distinguished Professor of Medicine in the Division of Endocrinology and Metabolism, and an international team of researchers, present new findings regarding a new high-dose formulation of oral semaglutide. Their study, which was published in The Lancet, found that once-daily oral semaglutide doses of 25 milligrams (mg) and 50 mg reduced blood sugar levels and increased weight loss compared to the lowest dose of 14 mg. Good job promoting.

“Low doses of GLP-1 receptor agonists are really potent at reducing A1c, or the average glucose in the blood,” said Buse, co-director of the NC Translational and Clinical Sciences Institute. “Whereas, the higher dose is really good for weight loss. On average, patients lost eight kilograms (17.5 pounds) on 50 milligrams, which is almost double the weight gain we saw with the lowest dose.”

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The new study is in line with other studies emphasizing the use of oral GLP-1 receptor agonists as a treatment for obesity.

In total, 1,606 participants, who were male and aged 58.2 years on average, participated in the Phase 3 program pending regulatory approval. The participants were randomized into three groups and asked to take oral semaglutide once a day. Each group took a different dose of semaglutide for 52 weeks, either the 14 mg dose, the 25 mg dose, or the 50 mg dose.

Blood sugar levels are measured through a percentage, called the A1C. According to the American Diabetes Association, most adults with diabetes need an A1C of less than 7% to be considered healthy. The A1C of all participants in the trial ranged between 8.0% and 10.5%.

The researchers found that those who received the 25 mg and 50 mg doses of oral semaglutide were 7.0% more likely to reach their A1C goal than those who took 14 mg.

Semaglutide also causes weight loss by suppressing the appetite. At the end of 52 weeks, participants taking 50 mg of oral semaglutide had lost an average of 17.5 pounds. Those who took 25 mg and 14 mg lost 14.8 pounds and 10 pounds, respectively.

During the trial, researchers noted side effects. The most common side effect was nausea due to the drug’s effect on stomach fullness. Some participants, especially those who took the higher doses of 25 mg and 50 mg, experienced vomiting, diarrhea, and/or constipation.