What question did this study set out to answer?

This study aimed to evaluate the effects of oral semaglutide on glycaemic control and related health markers in individuals with type 2 diabetes who are naïve to GLP-1 receptor agonists.

June 7, 2026

1704-P: Nationwide Real-World Retrospective Study of Oral Semaglutide Use in Patients with Type 2 Diabetes in Finland

Key Points

This study aimed to evaluate the effects of oral semaglutide on glycaemic control and related health markers in individuals with type 2 diabetes who are naïve to GLP-1 receptor agonists.
Identified individuals with type 2 diabetes initiating oral semaglutide from national registers.
Followed patients from April 1, 2021, to June 30, 2024, with primary endpoints at 180 and 365 days.
Examined changes in HbA1c, body weight, and various lipid profile components.
Mean HbA1c decreased from 7.9% to 6.9% at 180 days (n=1097; p<0.0001) and to 6.8% at 365 days (n=566; p<0.0001).
Body weight declined from 106 kg to 101 kg at 180 days (n=291; p<0.0001) and to 99 kg at 365 days (n=180; p<0.0001).
Significant reductions in LDL cholesterol, total cholesterol, triglycerides, and alanine aminotransferase were observed at both time points, all with p<0.0001.

Abstract

Introduction and Objective: This Finnish nationwide retrospective real-world study evaluated effects of oral semaglutide on glycaemic control, body weight, lipid profile, and liver enzymes in adults with type 2 diabetes (T2D) and naïve to any GLP-1 receptor agonists in Finland. Methods: People living with T2D in Finland who initiated oral semaglutide between April 1, 2021, and December 31, 2023, were identified from national registers and followed until June 30, 2024. Primary endpoints were changes in HbA1c and body weight from baseline to 180 and 365 days. Secondary endpoints included changes in low-density lipoprotein LDL-cholesterol (LDLc), high-density lipoprotein cholesterol, total cholesterol (TC), triglycerides (TG), and alanine aminotransferase (ALT). Results: We identified 7249 GLP-1-naïve persons living with T2D who initiated oral semaglutide. Of them, 46.7% were females, and 12.7% were 75 years of age or older. At 180 days, 65.8% remained on treatment and 55.2% at 365 days. Among those who discontinued oral semaglutide, one-fourth switched to injectable semaglutide. People with repeated measurements showed mean HbA1c decrease from 7.9% to 6.9% at 180 days (n = 1097; 95% CI: -1.1 to -1.0; p 0.0001) and to 6.8% at 365 days (n = 566; 95% CI: -1.2 to -1.0; p 0.0001). Mean body weight declined from 106 to 101 kg at 180 days (n = 291; 95% CI: -6 to -5; p 0.0001) and to 99 kg at 365 days (n = 180; 95% CI: -7 to -6; p 0.0001). LDLc (n = 384, mean change -0.5 mmol/L, 95% CI: -0.6 to -0.4; p 0.0001), TC (n = 267, mean change -0.4 mmol/L, 95% CI: -0.6 to -0.3; p 0.0001), and TG (n = 262, mean change -0.6 mmol/L, 95% CI: -0.8 to -0.4; p 0.0001) were significantly reduced at 180 days with little further change at 365 days. Mean ALT declined from 49 to 41 U/l at 180 days (n = 611, 95% CI: -9 to -6, p 0.0001) and from 48 to 38 U/l at 365 days (n = 431; 95% CI: -13 to -8; p 0.0001). Conclusion: Oral semaglutide significantly improves glycaemic and lipid control, body weight, and reduces ALT in T2D patients treated in clinical practice. Disclosure J.A. Vadén: Speaker's Bureau; Current; Amgen K.K., Boehringer Ingelheim International GmbH, Eli Lilly and Company, AstraZeneca. Advisory Panel; Ended; Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk. M. Lahelma: None. L. Nurmi: None. E.K. Heikkilä: None. H. Vessari: Employee; Current; Novo Nordisk. Stock/Shareholder; Current; Novo Nordisk. H. Luoto: Employee; Current; Novo Nordisk. Stock/Shareholder; Current; Novo Nordisk A/S. T. Saukkonen: Employee; Current; Novo Nordisk A/S. Stock/Shareholder; Current; Novo Nordisk A/S. L.K. Niskanen: Advisory Panel; Current; Amgen Inc. Speaker's Bureau; Ended; Boehringer Ingelheim International GmbH. Speaker's Bureau; Current; Lilly Diabetes, Novo Nordisk. Stock/Shareholder; Current; Novo Nordisk. Speaker's Bureau; Current; Amgen Inc. Speaker's Bureau; Ended; AstraZeneca. Speaker's Bureau; Current; GlaxoSmithKline plc. Advisory Panel; Current; Lilly Diabetes. Speaker's Bureau; Current; Menarini Group. Funding Novo Nordisk Farma Oy

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