Hormonal
Once-weekly subcutaneous semaglutide 2.4 mg combined with diet and exercise reverses prediabetes in approximately 80% of patients with obesity, significantly outperforming diet and exercise alone (12% reversal rate).
If you have obesity and prediabetes, adding once-weekly semaglutide 2.4 mg to your diet and exercise plan significantly increases your chances of reversing prediabetes (from 12% to 80%). This treatment also lowers BMI by ~14% and reduces cardiovascular risks. It requires weekly injections and ongoing lifestyle efforts, as stopping the drug may lead to weight regain and return of prediabetes.
At 52 weeks, semaglutide plus D&E and D&E alone reversed prediabetes in 80% and 12% of patients, and decreased BMI by 13.9% and 2.7%, respectively.
Why this rating
Based on a Phase 3 randomized controlled trial (STEP 10) with a clear treatment arm, though the 52-week duration is short for hard cardiovascular endpoints.
Source
The cost-effectiveness of subcutaneous semaglutide 2.4 mg in the management of people living with obesity and prediabetes in England
Mafalda Ramos et al. · Journal of Medical Economics · 2025
DOI 10.1080/13696998.2025.2575692
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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