Semaglutide is an incretin mimetic, glucagon-like peptide-1 (GLP-1) receptor agonist that is administered once-weekly by subcutaneous injection to improve glycemic control in adults with type 2 diabetes. It mimics the effects of GLP-1, a hormone released from the gastrointestinal tract in response to food intake that increases insulin secretion, suppresses glucagon secretion, and slows gastric emptying.
Semaglutide was approved by the FDA in 2017 and has been shown in clinical trials to be highly effective at lowering HbA1c and fasting blood glucose levels in patients with type 2 diabetes. Some of the main benefits of semaglutide therapy include:
Semaglutide is an important new option in the treatment of type 2 diabetes, especially for patients struggling with high blood sugars despite using other medications. Vitality Hormone Clinic provides semaglutide injections and ongoing diabetes care and education in Stokesdale, North Carolina.
Semaglutide may be an appropriate treatment option for adults with type 2 diabetes that are not achieving their target blood sugar levels with lifestyle modifications and other oral medications. Ideal candidates include:
Semaglutide should not be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2. It should be used with caution in patients with kidney impairment, diabetic retinopathy, gastrointestinal disease, or congestive heart failure.
Patients do not need to fail other medications first to be a candidate for semaglutide, as it can be used as monotherapy or as an add-on treatment to oral medications or insulin. Semaglutide is not just for patients with uncontrolled diabetes - it can also help patients meet tighter glycemic targets or assist with weight loss goals.
Semaglutide helps improve blood sugar control through several mechanisms of action:
The combination of these effects enables semaglutide to lower HbA1c and fasting glucose substantially in patients with type 2 diabetes. It works to restore first phase insulin response, suppress inappropriately high glucagon secretion, and reduce caloric intake – together improving glycemic control.
Semaglutide is given as a once-weekly subcutaneous injection, with a recommended starting dose of 0.25 mg. The dose is increased to 0.5 mg after 4 weeks, then to 1 mg after another 4 weeks (if needed to further improve control or assist with weight loss goals).
The semaglutide pen injector is easy to learn to use. The injections are administered under the skin of the abdomen, thigh, or upper arm. Rotation of injection sites is recommended with each dose.
Most patients will reach a maintenance dose of 1 mg weekly. The effects of each dose last about a week, providing 24/7 blood sugar lowering coverage with the convenience of once-weekly dosing.
There is no fixed duration for semaglutide treatment. It can be taken long-term as long as it continues providing benefits such as acceptable blood sugar control, weight loss, reduced cardiovascular risk, or avoidance of hypoglycemia.
If semaglutide is discontinued, its effects wear off over several weeks. Blood glucose and A1c levels will likely rise back to pre-treatment elevations.
Extensive clinical research has demonstrated that semaglutide is highly effective at lowering blood glucose and A1c in patients with type 2 diabetes. Key findings on its efficacy include:
This robust evidence demonstrates semaglutide is one of the most effective GLP-1 medications for improving glycemic control and assisting with weight loss in type 2 diabetes. The effects are proven with semaglutide as monotherapy or add-on therapy.
A large clinical trial called SUSTAIN 6 evaluated the cardiovascular safety and outcomes of semaglutide vs. placebo in adults with type 2 diabetes. Some highlights of the findings include:
The researchers concluded semaglutide has robust cardioprotective effects in patients with type 2 diabetes, above and beyond its glucose lowering action. The reasons are likely multifactorial - improved glucose control, weight loss, blood pressure reduction, and other positive effects on cardiovascular risk factors.
The most common side effects with semaglutide are gastrointestinal in nature, as it slows gastric emptying and impacts gut hormones:
Hypoglycemia is uncommon with semaglutide monotherapy but can occur when combined with insulin or insulin secretagogues like sulfonylureas. Medication adjustments may be required to reduce hypoglycemia risk.
Semaglutide has not been shown to increase risk of thyroid C-cell tumors, pancreatitis, or other serious adverse effects. It should not be used in patients at risk for medullary thyroid carcinoma. Kidney function should be monitored, as GLP-1 drugs can slightly increase serum creatinine levels.
Semaglutide is most effective when combined with a healthy lifestyle approach to managing type 2 diabetes. Recommendations include:
Combining semaglutide with therapeutic lifestyle changes gives the best chance of achieving hemoglobin A1c goals and reducing risks of diabetic complications. Healthy behaviors also support mental health on this journey.
The endocrinology experts at Vitality Hormone Clinic in Stokesdale, North Carolina provide cutting-edge, evidence-based care for patients with diabetes and other hormone disorders. Key reasons to choose us for semaglutide therapy include:
At Vitality Hormone Clinic, your endocrine health is our passion. We look forward to partnering with you on your journey to better health with semaglutide and comprehensive diabetes care.