Key result
Higher baseline vitamin D links to ~1.3-point greater BMI reduction during semaglutide therapy.
Why the study?
Semaglutide offers robust glycemic control and weight reduction in T2D, and vitamin D is implicated in metabolic regulation, yet the influence of baseline vitamin D levels on semaglutide-induced outcomes remained unclear.
Does higher baseline vitamin D level improve glycemic control, weight loss, and lipid profile responses to semaglutide in adults with type 2 diabetes?
Cross-Sectional (n=5,300)
Does higher baseline vitamin D level improve glycemic control, weight loss, and lipid profile responses to semaglutide in adults with type 2 diabetes?
In patients with type 2 diabetes initiating semaglutide, higher baseline vitamin D levels were independently associated with greater 12-month reductions in HbA1c and BMI, though no effect was seen on lipid profiles.
Objective Semaglutide, a glucagon-like peptide-1 receptor agonist, is an established therapy for type 2 diabetes (T2D), offering robust glycemic control and weight reduction. Vitamin D has been implicated in metabolic regulation, yet its influence on semaglutide-induced outcomes remains unclear. Research Design and Methods: We conducted a cross-sectional analysis of 5,300 adults with T2D, enrolled in Leumit Health Services, who initiated semaglutide therapy between February 1, 2019, and December 31, 2022. All patients had documented serum 25-hydroxyvitamin D [25(OH)D] levels prior to treatment initiation. Metabolic outcomes- including glycemic control (HbA1c), body mass index (BMI), and lipid profile- were assessed at 12 months. Associations between baseline 25(OH)D levels and metabolic changes were evaluated using multivariable regression models, adjusted for demographic and clinical covariates. Results The median baseline 25(OH)D level was 19.3 ng/mL. Compared with patients with vitamin D levels <15 ng/mL, those with levels of 15–24.9 ng/mL and ≥25 ng/mL exhibited greater reductions in HbA1c (β = –0.083, 95% CI [–0.154 to –0.013], p = 0.020; and β = –0.096, 95% CI [–0.017 to –0.017], p = 0.016, respectively) and BMI (β = –1.02, 95% CI [–1.46 to –0.58]; and β = –1.29, 95% CI [–1.77 to –0.80]; both p < 0.0001). No association was found with lipid profile. Conclusion Higher baseline vitamin D levels are independently associated with enhanced glycemic and weight loss responses to semaglutide in individuals with T2D. Prospective trials are warranted to explore whether vitamin D supplementation may potentiate semaglutide's metabolic effects.
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Fanne et al. (2026) conducted a cross-sectional in Type 2 diabetes (n=5,300). Higher baseline serum 25-hydroxyvitamin D levels (15–24.9 and ≥25 ng/mL) in patients initiating semaglutide vs. Baseline serum 25-hydroxyvitamin D <15 ng/mL was evaluated on Metabolic outcomes including glycemic control (HbA1c), body mass index (BMI), and lipid profile at 12 months (β = -0.096 (HbA1c for ≥25 ng/mL); β = -1.29 (BMI for ≥25 ng/mL), 95% CI -1.77 to -0.80, p=0.016 (HbA1c); <0.0001 (BMI)). Baseline 25(OH)D ≥25 vs <15 ng/mL in semaglutide-treated T2D patients was associated with greater 12-month reductions in HbA1c (β=-0.096, p=0.016) and BMI (β=-1.29, p<0.0001).
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