The Effects of Semaglutide in Adults (18+) with Overweight or Obesity and Diabetes type 2. A Narrative Review
Main Article Content
Abstract
Background and aim: Semaglutide (Ozempic) is one of the innovative medications relating to a family of GLP-1 receptor agonists which was produced by the pharmaceutical company Novo Nordisk to address a clinical need for the effective weight lowering treatment, particularly for the overweight and obese people with diagnosis of Diabetes type 2. Semaglutide was used as monotherapy or added as a supplemental treatment to a basal insulin or other oral anti-diabetic drugs. According to the results of several clinical trials, semaglutide showed an ability to provoke significant weight loss, improve glycemic control, cardiometabolic and cardiovascular parameters. However, despite undeniable benefits, treatment with semaglutide induced adverse effects, among which gastrointestinal disorders were the most frequently reported. The aim of this study is to investigate treatment effects, benefits and drawbacks of semaglutide in the overweight or obese adult (18+) patients with Diabetes type 2.
Methods: This study used a narrative synthesis of retrieved research data. The existing literature on the topic was searched through the PubMed, Clinicaltrials.gov and Google Scholar electronic databases: The search was limited to research studies conducted within 2016-2025 years, systematic reviews, clinical trials, randomized controlled trials, meta-analyses, editorials, published in English language, full-free text peer-reviewed articles. The following research finding were analyzed- efficacy parameters of semaglutide- glycaemic control (change in endogenous insulin secretion, C-peptide, change in the levels of HbA1c, fasting and postprandial plasma glucose, mean change in body weight, cardiometabolic parameters (total cholesterol, triglycerides, systolic and diastolic blood pressure, waist circumference); safety parameters – hypoglycaemia, gastrointestinal disorders (pancreatitis, nausea, diarrhoea, vomiting), malignant neoplasma.
Findings: The analysis of research findings on glycemic control, body weight, cardiometabolic parameters and adverse effects retrieved out of two reviews and six clinical trials demonstrated a high clinical effectiveness of both oral and subcutaneous semaglutide in reducing body weight, HbA1c levels, fasting plasma glucose levels. The effects of semaglutide are dosage-dependent, higher dosages of oral semaglutide were associated with a more pronounced effect. In addition to this, treatment with semaglutide resulted in an improvement in waist circumference, total cholesterol, triglycerides, systolic and diastolic blood pressure. Among adverse events, the most common side effects of semaglutide appeared to be nausea, diarrhoea and vomiting of mild severity and short-term duration, a few cases of pancreatitis and malignant neoplasms were identified; the rate for hypoglycemia was low. The frequency of these events was closely associated with higher dosages of semaglutide.
Conclusion: In conclusion, this narrative review revealed and confirmed that semaglutide significantly improves body weight, glycemic control and cardiometabolic parameters in overweight or obese adult (18+) patients with Diabetes type 2 in both oral and injectable formations. However, prescription of semaglutide must be arranged with cautions, excluding candidate with pre-existing gastrointestinal disorders like pancreatitis, cholelithiasis, gastritis and etc, family history of thyroid cancer, multiple endocrine neoplasia and other thyroid associated disorders. Generally, with compliance to above mentioned conditions, semaglutide can be used as an effective medication for monotherapy or a supplemental therapy in overweight or obese adult (18+) patients with Diabetes Type 2.
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