Hormonal
Oral semaglutide at 7 mg/d and 14 mg/d, when added to metformin with or without sulfonylurea, significantly reduces glycated hemoglobin (HbA1c) and body weight compared to sitagliptin in adults with type 2 diabetes.
If you have type 2 diabetes that isn't well-controlled with metformin (with or without sulfonylurea), adding oral semaglutide at 7 mg or 14 mg daily can significantly lower your HbA1c and help you lose weight compared to taking sitagliptin. Start with 3 mg, then increase to 7 mg after 4 weeks, and finally to 14 mg after another 4 weeks. Take it first thing in the morning with water, at least 30 minutes before eating or taking other medications. The 3 mg dose alone is not effective for lowering HbA1c compared to sitagliptin, so sticking to the higher doses is important.
Semaglutide, 7 and 14 mg/d, compared with sitagliptin, significantly reduced HbA1c (differences, –0.3% [95% CI, –0.4% to –0.1%] and –0.5% [95% CI, –0.6% to –0.4%], respectively; P < .001 for both) and body weight (differences, –1.6 kg [95% CI, –2.0 to –1.1 kg] and –2.5 kg [95% CI, –3.0 to –2.0 kg], respectively; P < .001 for both) from baseline to week 26.
Why this rating
Phase 3, randomized, double-blind, double-dummy, parallel-group clinical trial with a large sample size (n=1864) and rigorous statistical analysis.
Source
Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea
Julio Rosenstock et al. · JAMA · 2019
DOI 10.1001/jama.2019.2942
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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