Hormonal
Semaglutide induces significant weight loss in type 2 diabetes patients across all BMI subgroups, with the effect being primarily direct rather than mediated by gastrointestinal side effects.
If you have type 2 diabetes, semaglutide (0.5mg or 1.0mg once weekly) will likely help you lose weight (2-6kg more than other common diabetes drugs), regardless of your starting weight. This weight loss happens directly through hormonal mechanisms, not just because you feel nauseous, although nausea is a common side effect.
semaglutide-induced weight loss was consistently greater versus comparators, regardless of baseline BMI. The contribution of nausea or vomiting to this weight loss was minor.
Why this rating
Post hoc analysis of multiple large phase 3a RCTs (SUSTAIN 1-5).
Source
Semaglutide induces weight loss in subjects with type 2 diabetes regardless of baseline <scp>BMI</scp> or gastrointestinal adverse events in the SUSTAIN 1 to 5 trials
Bo Åhrén et al. · Diabetes Obesity and Metabolism · 2018
DOI 10.1111/dom.13353
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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