New practice in semaglutide on type-2 diabetes and obesity: clinical evidence and expectation

doi:10.1007/s11684-021-0873-2

Front. Med.

2022, Vol. 16

Issue (1) : 17-24 https://doi.org/10.1007/s11684-021-0873-2

REVIEW

New practice in semaglutide on type-2 diabetes and obesity: clinical evidence and expectation

Yalin Liu, Xianghang Luo(

)

Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha 410008, China

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Abstract

Obesity is an important risk factor of type 2 diabetes (T2D), which has become an important factor threatening human health. However, no perfect drug choice for obesity exists. Semaglutide is a kind of human glucagon-like peptide-1 (GLP-1) analog that promotes insulin secretion while inhibiting glucagon secretion through a glucose concentration-dependent mechanism. GLP-1 can also delay stomach emptying and suppress appetite to help lose weight. This review summarizes clinical evidence of the semaglutide effect on T2D and obesity and establishes expectations on future clinical trials for obesity treatment.

Keywords semaglutide type 2 diabetes obesity

Corresponding Author(s): Xianghang Luo

Just Accepted Date: 16 November 2021 Online First Date: 25 February 2022 Issue Date: 28 March 2022

Cite this article:

Yalin Liu,Xianghang Luo. New practice in semaglutide on type-2 diabetes and obesity: clinical evidence and expectation[J]. Front. Med., 2022, 16(1): 17-24.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-021-0873-2
https://academic.hep.com.cn/fmd/EN/Y2022/V16/I1/17

Fig.1 Regulatory mechanism of semaglutide.

Trial	Patients (n)	Intervention	Duration (week)	Main inclusion ?criteria	Frequency	Supplementary ?measure	Test result
Astrup ?[64]	564	Liraglutide; ?orlistate; ?placebo	20	Obese ?adults	Subcutaneously ?administered ?once a day	With an energy-?deficit diet of ?500 kcal per day ?and increasing ?physical activity	Liraglutide 1.2, 1.8, 2.4, and 3.0 mg groups lost ?4.8, 5.5, 6.3, and 7.2 kg, respectively, ?whereas the placebo group lost 2.8 kg and ?the orlistat lost 4.1 kg. The liraglutide 3.0 mg ?group had 76% of the weight loss more than ?5%, the placebo group had 30% and the ?orlistat group had 44%
Rosenstock ?[65]	152	Exenatide; ?placebo	24	Obese adults ?without T2D	−	With lifestyle ?intervention	The exenatide group lost 5.1±0.5 kg from the ?baseline 109.5±2.7 kg, whereas the placebo ?group lost 1.6±0.5 kg from the baseline ?107.6±2.6 kg
Lundkvist ?[66]	50	Dapagliflozin+ ?exenatide; ?placebo	24	Obese adults ?without T2D	Oral dapagliflozin ?10 mg once a day?+ subcutaneous ?exenatide 2 mg ?once a week	With a balanced ?diet and ?moderate ?exercise	Dapagliflozin 10 mg once a day+ exenatide 2 ?mg once a week group lost 4.48 kg, whereas ?the placebo group lost 0.35 kg. The experi?mental group had 36% of the weight loss ?more than 5%, the placebo group had 4.2%
Pratley ?[67]	295	Efpeglenatide; ?placebo	20	Obese adults	Once or twice a ?week	With a hypocaloric ?diet	Efpeglenatide (4 mg once a week, 6 mg once a ?week, 6 mg once every 2 week, and 8 mg ?once every 2 week) groups lost 6.6, 7.3, 6.4, ?and?7.1 kg, respectively, whereas the ?placebo group lost 0.1 kg
Wilding ?[49]	1961	Semaglutide; ?placebo	68	Obese adults ?without T2D	Subcutaneously ?administered ?once a week	With lifestyle ?intervention	In all randomized patients, the semaglutide 2.4 ?mg treatment group lost 14.9% from the ?average baseline weight of 105.3 kg, ?whereas the placebo group lost 2.4%. ?Meanwhile, 86.4% of the semaglutide 2.4 ?mg group lost more than 5%, and 31.5% of ?the placebo group lost more than 5%

Tab.1 Effects of different GLP-1 receptor agonists on losing weight

Fig.2 In the research of Wilding et al. [49], people in the semaglutide 2.4 mg treatment group lost 14.9% weight from the average baseline weight of 105.3 kg, whereas those in the placebo group lost 2.4%. Meanwhile, 86.4% of people in the semaglutide 2.4 mg group lost≥5% weight, and 31.5% of those in the placebo group lost more than 5%.

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