Semaglutide is an injectable medication used to improve blood sugar control in adults with type 2 diabetes. It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists.
Some key benefits of semaglutide include:
- Improved A1C levels: Multiple studies have shown that semaglutide can lead to significant reductions in A1C levels (a key marker of long-term blood sugar control). Reductions of 1.0-1.9% have been observed over 6-12 months.
- Weight loss: Semaglutide often results in moderate weight loss, on the order of 10-15 pounds over 6-12 months. This appears to be due to reductions in appetite and calorie intake. The weight loss effects may help improve insulin sensitivity.
- Low risk of hypoglycemia: Clinical trials have shown that semaglutide does not increase the risk of dangerous low blood sugar levels (hypoglycemia) when used alone. The risk does increase when combined with medications like sulfonylureas.
- Cardiovascular benefits: The large SUSTAIN-6 trial demonstrated a 26% reduction in the risk of cardiovascular death, non-fatal heart attack, or non-fatal stroke with semaglutide versus placebo. This suggests cardio-protective effects.
- Potential to reduce or eliminate additional medications: Due to its glucose-lowering and weight loss effects, semaglutide may allow reduction or elimination of other diabetes medications like insulin, sulfonylureas, SGLT2 inhibitors, etc.
- Once weekly dosing: Semaglutide is injected subcutaneously once per week. This may increase compliance versus medications that require more frequent administration.
Some key things to know about using semaglutide:
- The most common side effects are temporary GI problems like nausea, vomiting, and diarrhea. These tend to improve over time.
- It may take several weeks to months to achieve the full glucose-lowering benefit. Doses are incrementally increased to improve tolerability.
- Semaglutide requires prior authorization from most insurance plans due to its high cost (over $1000 per month in the US). Out-of-pocket costs can be prohibitive for some patients. Manufacturer discounts and copay programs may reduce expenses.
- It interacts with certain other diabetic medications like insulin and sulfonylureas, sometimes requiring dose adjustments to prevent hypoglycemia. So coordination with the healthcare team is important.
In summary,
semaglutide provides substantial
A1C and weight reduction, with the added benefits of
low hypoglycemia risk and
positive cardiovascular outcomes. Its use does require some patience during ramp-up of dosing to manage temporary GI side effects. And the high costs mean insurance coverage and/or financial assistance programs are key considerations for most patients. But for many with type 2 diabetes, semaglutide can be a valuable medication to help achieve blood sugar control and reduce complications long-term.