Effect of Semaglutide on Weight, HbA1c Reduction, and Side Effect Profile in Type 2 Diabetes Patients
DOI:
https://doi.org/10.36283/ziun-pjmd14-4/074Keywords:
Diabetes Mellitus, Type 2, Hypoglycemic Agents, Glucagon-Like Peptide 1, Weight Loss, Semaglutide, HbA1c, Adverse EffectsAbstract
Background:
Type 2 Diabetes Mellitus (T2DM) is a major public health challenge, with a rising prevalence in Pakistan and globally. Poor glycemic control and obesity are common among patients with T2DM, increasing the risk of complications. Semaglutide, a once-weekly GLP-1 receptor agonist, has shown promise in reducing both HbA1c levels and body weight. This study aimed to evaluate the impact of Semaglutide on glycemic control and weight loss, and to assess the frequency of its side effects in patients with T2DM.
Methodology:
A quasi-experimental study was conducted over six months at the Department of Medicine, Rehman Medical Institute, Peshawar over six months i-e from 1th March 2025 to 31st August 2025. A total of 101 patients with T2DM, aged 25–60 years, with a BMI ≥27 kg/m² and HbA1c >7.5%, were included using non-probability consecutive sampling. Semaglutide was administered weekly for 12 weeks. Baseline and post-treatment weight and HbA1c were recorded. Side effects were also documented. Data were analyzed using SPSS v20; paired t-tests were applied with p ≤ 0.05 as statistically significant.
Results:
Mean HbA1c decreased from 9.1 ± 1.2% to 7.5 ± 1.1% (p < 0.001) and mean weight reduced from 88.5 ± 9.3 kg to 82.9 ± 8.7 kg (p < 0.001). Common side effects included nausea (27.7%), diarrhea (11.9%), and vomiting (8.9%); 40.6% reported no side effects.
Conclusion:
Semaglutide significantly improved glycemic control and promoted weight loss with an acceptable safety profile. It is an effective therapeutic option for managing T2DM in real-world clinical settings.
References
REFERENCES
1. Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences. 2020;21(17):6275.
2. Joseph JJ, Deedwania P, Acharya T, Aguilar D, Bhatt DL, Chyun DA, et al. Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: a scientific statement from the American Heart Association. Circulation. 2022;145(9):e722-e59.
3. Bae JH, Han K-D, Ko S-H, Yang YS, Choi JH, Choi KM, et al. Diabetes fact sheet in Korea 2021. Diabetes & Metabolism Journal. 2022;46(3):417-26.
4. Kumar A, Gangwar R, Ahmad Zargar A, Kumar R, Sharma A. Prevalence of diabetes in India: A review of IDF diabetes atlas 10th edition. Current diabetes reviews. 2024;20(1):105-14.
5. Hasan SU, Siddiqui MR. Nationwide prevalence of type 2 diabetes mellitus and pre-diabetes in Pakistan: A systematic review and meta-analysis. Diabetes Research and Clinical Practice. 2024:111815.
6. Padgilwar S, Sanghai D, Patond V, Pundkar S, Jadhao M, Wankhade M, et al. Recent Drug Advances in the Management of Diabetes Complications: An Overview. Tuijin Jishu/Journal of Propulsion Technology. 2023;44(4):2023.
7. Sarma S, Sockalingam S, Dash S. Obesity as a multisystem disease: Trends in obesity rates and obesity‐related complications. Diabetes, Obesity and Metabolism. 2021;23:3-16.
8. Henning RJ. Obesity and obesity-induced inflammatory disease contribute to atherosclerosis: a review of the pathophysiology and treatment of obesity. American journal of cardiovascular disease. 2021;11(4):504.
9. Olanrewaju OA, Sheeba F, Kumar A, Ahmad S, Blank N, Kumari R, et al. Novel therapies in diabetes: a comprehensive narrative review of GLP-1 receptor agonists, SGLT2 inhibitors, and beyond. Cureus. 2023;15(12).
10. Alharbi SH. Anti-inflammatory role of glucagon-like peptide 1 receptor agonists and its clinical implications. Therapeutic Advances in Endocrinology and Metabolism. 2024;15:20420188231222367.
11. Camilleri M, Lupianez-Merly C. Effects of GLP-1 and other gut hormone receptors on the gastrointestinal tract and implications in clinical practice. Official journal of the American College of Gastroenterology| ACG. 2022:10.14309.
12. Binou P, Stergiou A, Kosta O, Tentolouris N, Karathanos VT. Positive contribution of hydroxytyrosol-enriched wheat bread to HbA1c levels, lipid profile, markers of inflammation and body weight in subjects with overweight/obesity and type 2 diabetes mellitus. European Journal of Nutrition. 2023;62(5):2165-76.
13. Frías JP, Auerbach P, Bajaj HS, Fukushima Y, Lingvay I, Macura S, et al. Efficacy and safety of once-weekly semaglutide 2· 0 mg versus 1· 0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial. The Lancet Diabetes & Endocrinology. 2021;9(9):563-74.
14. Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nature medicine. 2022;28(10):2083-91.
15. Amaro A, Sugimoto D, Wharton S. Efficacy and safety of semaglutide for weight management: evidence from the STEP program. Postgraduate Medicine. 2022;134(sup1):5-17.
16. Wajid M, Sattar S, Khalid F, Masood MQ. Efficacy and tolerability of semaglutide in patients with type-2 diabetes mellitus: Experience of a tertiary care hospital, Pakistan. Clinical Medicine Insights: Endocrinology and Diabetes. 2023;16:11795514231213568.
17. Amamoo J, Doshi R, Noone J, Xie L, Gamble C, Guevarra M, et al. Once-Weekly Semaglutide Versus Sodium-Glucose Co-transporter 2 Inhibitors: Real-World Impact on Weight, HbA1c, and Healthcare Resource Utilization in Type 2 Diabetes (PAUSE). Diabetes Therapy. 2025:1-16.
18. Chen H, Li X-Z, Chen J-Q, Ren T-S, Zhang Y-S, Wang Y-N, et al. Comparative efficacy and safety of glucagon-like peptide 1 receptor agonists for the treatment of type 2 diabetes: a network meta-analysis. Medicine. 2023;102(27):e34122.
19. Campforts B, Drukker M, van Amelsvoort T, Bak M. Management of obesity with semaglutide or metformin in patients with antipsychotic-induced weight gain (MOSA): a non-randomised open-label pilot study. BMC psychiatry. 2024;24(1):865.
20. Qin W, Yang J, Deng C, Ruan Q, Duan K. Efficacy and safety of semaglutide 2.4 mg for weight loss in overweight or obese adults without diabetes: An updated systematic review and meta‐analysis including the 2‐year STEP 5 trial. Diabetes, Obesity and Metabolism. 2024;26(3):911-23.
21. Smits MM, Van Raalte DH. Safety of semaglutide. Frontiers in endocrinology. 2021;12:645563.
22. Wan J, Ferrari C, Tadros M. GLP-1RA essentials in gastroenterology: side effect management, precautions for endoscopy and applications for gastrointestinal disease treatment. Gastroenterology Insights. 2024;15(1):191-212.
23. Alanazi SA. Safety and efficacy of glucagon-like peptide-1 receptor agonists and their effect on weight loss.
24. Roy Chowdhury S, Sadouki F, Collins E, Keen F, Bhagi R, Lim YS, et al. Real-world use of oral and subcutaneous semaglutide in routine clinical practice in the UK: a single-centre, retrospective observational study. Diabetes Therapy. 2024;15(4):869-81.
25. Rajput R, Sinha B, Lodha S, Deb P, Das S, Agarwal S, et al. GLP-1 Receptor Agonists Critical Review: Revisiting Its Positioning for Type 2 Diabetes Mellitus in Routine Clinical Practice in India. Clinical Diabetology. 2022;11(4):269-93.
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