The risk of type 2 diabetes (T2D) is more than halved with weekly injections of the new obesity drug semaglutide, according to new research being presented at the annual meeting of the European Association for the Study of of Diabetes (EASD) in Stockholm, Sweden (19). -September 23).
Semaglutide was recently approved in the US to treat obesity and has been provisionally approved to treat obesity in England.
Semaglutide appears to be the most effective drug to date for treating obesity and is beginning to close the gap on the amount of weight loss after bariatric surgery.”
Dr. W. Timothy Garvey, Department of Nutritional Sciences, University of Alabama at Birmingham
“Its approval was based on clinical trial results showing that it reduces weight by more than 15% on average, when used in conjunction with a healthy lifestyle program.
“This amount of weight loss is sufficient to treat or prevent a wide range of obesity complications that impair health and quality of life and is a game changer in obesity medicine.”
Obesity is known to increase the risk of T2D at least sixfold, and Dr Garvey and colleagues were interested in whether semaglutide could reduce this risk.
To find out more, they performed a new analysis of data from two semaglutide trials.
In STEP1, participants (1,961) who were overweight or obese received an injection of 2.4 mg of semaglutide or a placebo weekly for 68 weeks.
STEP4 involved 803 overweight or obese participants. All received weekly injections of 2.4 mg semaglutide for 20 weeks. They then either remained on semaglutide or were switched to placebo for the next 48 weeks.
Participants in both trials received advice about diet and exercise.
The researchers used the cardiometabolic disease stage (CMDS) to predict participants’ risk of developing T2D in the next 10 years.
CDMS has previously been shown to be a very accurate measure of T2D risk and is calculated using a formula that takes into account the patient’s sex, age, race, BMI, and blood pressure, as well as blood glucose, HDL cholesterol and triglyceride levels.
In STEP1 participants who received semaglutide, 10-year T2D risk scores decreased by 61% (from 18.2% at week 0 to 7.1% at week 68).
This compares with a 13% reduction in risk score for those who received placebo (from 17.8% at week 0 to 15.6% at week 68).
Risk scores reflected weight loss, which was 17%, on average, with semaglutide versus 3% with placebo.
At the start of the trial, risk scores were higher in participants with prediabetes than in those with normal blood sugar levels. However, semaglutide reduced the risk by a similar amount in both groups.
In PAS 4 participants, the largest decreases in risk scores were seen in the first 20 weeks (from 20.6% at week 0 to 11.4% at week 20). In those who continued to receive semaglutide, the risk score dropped further to 7.7%, but in those who switched to placebo, it increased to 15.4%.
This indicates that sustained semaglutide treatment is needed to maintain T2D risk reduction
Dr Garvey says: “Semaglutide reduces the future risk of diabetes by more than 60% in obese patients – this figure is similar whether a patient has prediabetes or normal blood sugar levels.
“Sustained treatment is required to maintain the benefit.
“Given the rising rates of obesity and diabetes, semaglutide could be used effectively to reduce the burden of these chronic diseases.”