Optimization of nursing strategies for semaglutide treatment in overweight type 2 diabetes based on gene polymorphism

Objective To evaluate the impact of a gene polymorphism-based individualized nursing strategy on the efficacy of semaglutide in overweight type 2 diabetes (T2DM) patients and to assess its role in mitigating genotype-driven outcome disparities. Methods Eighty-three overweight T2DM patients initiating semaglutide were enrolled. The TCF7L2 rs7903146 polymorphism was detected via PCR-RFLP. Patients were stratified into a genetically advantageous group (Group A, CC genotype, n=49) and a non-advantageous group (Group B, CT/TT genotypes, n=34). Both groups received standard semaglutide therapy and routine care for the first month. Subsequently, Group B received a tailored, optimized nursing intervention for two additional months, while Group A continued routine care. Glycemic control, body weight, adverse events, and satisfaction were compared at baseline, 1 month, and 3 months. Results At 1 month, Group A showed superior reductions in fasting glucose, HbA1c, weight, and BMI compared to Group B (all P<0.05), with a higher composite target achievement rate (93.94% vs. 84.00%, P<0.05). After Group B received the optimized strategy, between-group differences in all efficacy parameters became non-significant by 3 months (P>0.05). Group B also demonstrated a significantly lower rate of gastrointestinal adverse reactions (11.76% vs. 28.57%, P<0.05) and higher nursing satisfaction (97.06% vs. 81.63%, P<0.05) at the study endpoint. Conclusion TCF7L2 CC genotype patients respond more rapidly to semaglutide. Implementing a genotype-informed optimized nursing strategy for CT/TT carriers after the first month reduces the initial efficacy gap, leading to similar outcomes by 3 months while improving tolerability and patient satisfaction. This approach merits further prospective evaluation.