Nationwide Real‐World Retrospective Study of Oral Semaglutide Use in Adults Living With Type 2 Diabetes in F inland

ABSTRACT Aim This Finnish nationwide retrospective 'real‐world' study evaluated the effects of oral semaglutide on glycaemic control, body weight, lipid profile, and liver enzymes in adults living with type 2 diabetes (T2D) and naïve to any GLP‐1 receptor agonists in Finland. Materials and Methods Adults living with T2D ( n = 7249) 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 182.5 and 365 days. Secondary endpoints included changes in LDL‐cholesterol, HDL‐cholesterol, total cholesterol, triglycerides, HDL/triglycerides ratio, and ALT. Results Of those initiating oral semaglutide, 65.8% remained on treatment at 180 days and 55.2% at 365 days. Among patients included in longitudinal trajectory modelling, mean HbA1c ( n = 2784) decreased from 7.9% to 6.8% at 182.5 days (95% CI: −1.20 to −1.04; p < 0.001) and to 6.9% at 365 days (95% CI: −1.18 to −0.95; p < 0.001). Mean body weight ( n = 832) declined from 106 to 100 kg at 182.5 days (95% CI: −7 to −5; p < 0.001) and to 98 kg at 365 days (95% CI: −10 to −6; p < 0.001). LDL‐cholesterol ( n = 1402), and triglycerides ( n = 975) were significantly reduced at 182.5 days with little further change at 365 days. Mean ALT ( n = 1762) declined from 50 to 42 U/L at 182.5 days (95% CI: −10 to −6, p < 0.001) and to 37 U/L at 365 days (; 95% CI: −16 to −10; p < 0.001). While weight at baseline was lower at patients aged at least 75 years, the changes in HbA1c and weight were similar compared to patients under 75 years of age. Conclusion Oral semaglutide significantly improves glycaemic and lipid control, body weight, and liver enzymes in adults living with T2D treated in clinical practice.