The efficacy and safety of once-daily oral semaglutide in adults with type 2 diabetes during Ramadan: A prospective observational study in Kuwait

Aims The study evaluated the efficacy and safety of once-daily oral semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), during the 2023 Ramadan fast. Methods This prospective, observational study is a sub-analysis of the O-SEMA–FAST study that includes 87 adults with type 2 diabetes in Kuwait. Endpoints were assessed pre-Ramadan and after 20 weeks. Adjusted means and changes in HbA1c (%) and body weight were estimated using a regression model controlling for covariates. Results Mean HbA1c (%) decreased from 6.7 (50 mmol/mol) ± 1.33 at baseline to 6.4 (46 mmol/mol) ± 1.20 at study end. After adjustment for age, sex, baseline weight and HbA1c, the mean difference was 0.32% ( p = 0.021). Mean body weight decreased from 90.41 kg ± 18.86 to 88.44 ± 19.68 kg ( p < 0.001), while adjusted weight declined from 88.64 kg to 88.16 kg [95% CI = 87.33–88.98], ( p = 0.045). Mean BMI decreased from 32.65 ± 5.98 kg/m 2 to 32.28 ± 6.0 kg/m 2 at the end of the study (p < 0.001). Conclusion Oral semaglutide use during Ramadan fasting was associated with modest improvements in HbA1c, body weight, and BMI, with few reported adverse events.