Real-world Effectiveness of Oral Semaglutide in Patients with Type 2 Diabetes Mellitus: A Retrospective Observational Study on Glycemic Control and Weight Reduction

Introduction: Type 2 diabetes (T2D) mellitus poses a major health burden in India, with poor glycemic control and obesity remaining key challenges. While GLP-1 receptor agonists (GLP-1RAs) offer glycemic and weight benefits, adherence to injectables is suboptimal. Oral semaglutide provides an alternative, requiring real-world evaluation in Indian patients. Subjects and Methods: This retrospective observational study analyzed electronic medical records from a clinical center in Delhi, India. Adults (≥18 years) with ≥1 year T2D on oral semaglutide were included, excluding type 1 diabetes, severe renal impairment, recent GLP-1RA use, pregnancy, or lactation. Outcomes – glycated hemoglobin (HbA1c), weight, fasting blood sugar (FBS), and postprandial blood sugar (PPBS), were assessed at 3, 6, 9, and 12 months. Statistical analyses included paired t -tests ( P < 0.05). Results: A total of 51 patients were included, with a mean age of 51.22 years and diabetes duration of 10.79 years. Significant reductions were observed in weight (mean reduction: 5.31 kg at 12 months, P = 0.006), HbA1c (mean reduction: 1.052%, P = 0.003), FBS (mean reduction: 36.39 mg/dL, P < 0.001), and PPBS (mean reduction: 54.4 mg/dL at 6 months, P = 0.040). Weight and glycemic parameters showed significant and progressive improvements over 12 months. Conclusions: Oral semaglutide demonstrated significant real-world effectiveness in glycemic control and weight reduction in Indian T2D patients. Dose adjustments and side-effect management strategies may enhance long-term adherence.