Cardiometabolic Effects of Semaglutide in Individuals with Type 2 Diabetes in the United Arab Emirates: Real-World 12-Month Outcomes and Predictors of Response

INTRODUCTION: There is little real-world evidence on semaglutide effectiveness in the United Arab Emirates (UAE), despite the high local burden of type 2 diabetes (T2DM) and obesity. The aim of this study was to evaluate real-world cardiometabolic outcomes and predictors of response following initiation of semaglutide in a tertiary endocrine clinic. METHODS: This was a retrospective, observational cohort study of adults with T2DM initiating once-weekly subcutaneous semaglutide (June 2022 to January 2025). Primary outcomes were changes in glycated hemoglobin (HbA1c), body weight, and systolic blood pressure (SBP) at 6 and 12 months. Responder and composite endpoints were assessed at 12 months. Predictors of glycemic (HbA1c reduction ≥ 1%) and composite response (HbA1c reduction ≥ 1% and ≥ 5% weight loss) were analyzed by multivariable logistic regression. RESULTS: In total, 278 patients were included. Adjusted HbA1c decreased by -0.89% (95% confidence interval (CI) -1.07 to -0.70) at 6 months and -0.71% (95% CI -0.91 to -0.50) at 12 months (both p < 0.001). Weight decreased by -3.09 kg (-4.19 to -2.00) and -4.77 kg (-6.00 to -3.53) at 6 and 12 months, respectively (p < 0.001). SBP decreased by -3.56 mmHg (-6.17 to -0.96; p = 0.007) at 6 months. Overall, 39% achieved an HbA1c reduction ≥ 1%, 43% achieved ≥ 5% weight loss, and 23% achieved the composite endpoint at 12 months. Higher baseline HbA1c predicted HbA1c response (odds ratio [OR] 1.85; 95% CI 1.26 to 2.88). CONCLUSION: Semaglutide improved glycemia and weight and resulted in modest reductions in SBP in real-world practice. These findings support semaglutide as an effective component of cardiometabolic risk reduction strategies in adults with T2DM in the region, especially in those with at-risk glycemic profiles.