Background: Type 2 diabetes (T2D) is a chronic and progressive metabolic disorder that poses a major global health challenge. With over 530 million people affected worldwide in 2021 and projections estimating this number will rise to 780 million by 2045, there is an urgent need for therapies that go beyond glycaemic control to address weight management, cardiovascular risk, and patient adherence. To summarize evidence from clinical trials and real-world studies evaluating the efficacy, safety, and broader clinical impact of oral and injectable semaglutide in diverse T2D populations. Methodology: A review of findings from multiple studies, including randomized controlled trials (PIONEER 11, Aroda et al., Bonora et al.) and real-world data (PIONEER REAL UK), assessing semaglutide’s impact on HbA1c, body weight, insulin use, and treatment satisfaction. Results: In a predominantly Chinese cohort, oral semaglutide (14 mg) led to significant reductions in glycosylated hemoglobin (HbA1c) and weight. High-dose subcutaneous semaglutide (up to 16 mg/week) showed superior glycaemic and weight loss outcomes in overweight/obese patients versus lower doses. In real-world settings, oral semaglutide was effective and well-tolerated, with nearly 50% of patients achieving HbA1c targets and reporting improved treatment satisfaction. Once-weekly semaglutide facilitated glycaemic improvement and insulin discontinuation in insulin-dependent patients. Gastrointestinal side effects were the most common adverse events but were generally mild and manageable. Conclusion: Semaglutide, in both oral and injectable formulations, is a versatile, effective, and well-tolerated option for T2D management. It improves glycaemic control, supports weight loss, simplifies treatment regimens, and may reduce the need for insulin, making it particularly beneficial for patients with comorbid obesity and cardiovascular risk.
Srivastava et al. (Thu,) studied this question.