Oral Semaglutide Significantly Improves Glycemic Control, Weight, Lipids, and Liver Enzymes in Finnish Type 2 Diabetes Patients

Type 2 Diabetes (T2D) is a progressive metabolic disorder characterized by hyperglycemia, often accompanied by obesity, dyslipidemia, and non-alcoholic fatty liver disease. Current treatments aim to improve glycemic control and mitigate cardiovascular risk, but achieving comprehensive metabolic improvement remains challenging for many patients. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are highly effective, yet their injectable nature can be a barrier to adherence. Oral GLP-1RAs offer a convenient alternative, and real-world data are crucial to understand their effectiveness and tolerability in diverse clinical settings, especially regarding broader metabolic benefits beyond glucose and weight.

This Finnish nationwide retrospective 'real-world' study analyzed 7249 adults with Type 2 Diabetes who initiated oral semaglutide between April 2021 and December 2023. Patients were identified from national registers and followed for up to 365 days, ensuring they were naive to any GLP-1RA prior to initiation. Primary endpoints were changes in HbA1c and body weight from baseline to 182.5 and 365 days. Secondary endpoints included changes in LDL-cholesterol, HDL-cholesterol, total cholesterol, triglycerides, HDL/triglycerides ratio, and ALT levels. The specific dose of oral semaglutide used was not detailed in the abstract, reflecting real-world prescribing practices.

Oral semaglutide demonstrated significant improvements across multiple metabolic parameters in adults with Type 2 Diabetes. At 180 days, 65.8% of patients remained on treatment, with 55.2% continuing at 365 days. Among patients included in longitudinal modeling, mean HbA1c (n=2784) decreased from 7.9% at baseline to 6.8% at 182.5 days (95% CI: -1.20 to -1.04; p<0.001) and to 6.9% at 365 days (95% CI: -1.18 to -0.95; p<0.001). Mean body weight (n=832) declined from 106 kg to 100 kg at 182.5 days (95% CI: -7 to -5; p<0.001).