A Significant Effect of Oral Semaglutide on Cardiovascular Risk Factors in Patients With Type 2 Diabetes

BACKGROUND: The once-daily glucagon-like peptide 1 (GLP-1) analogue, liraglutide has been shown to reduce major adverse cardiovascular events (MACE) and progression of chronic kidney disease (CKD). The once-weekly GLP-1 analogue, semaglutide also reduced MACE and renal events. Based on the evidence for GLP-1 analogues on MACE and renal events, the guideline recommended to treat high-risk diabetic individuals with GLP-1 analogues to reduce MACE and CKD progression. Recently, a once-daily oral semaglutide was developed and shown to reduce MACE. However, its effects on renal outcome and cardiovascular metabolic risk factors remain unknown. METHODS: We retrospectively picked up patients who had taken oral semaglutide from March 2021 to June 2022 and compared metabolic parameters at baseline with the data at 3, 6 months after the start of oral semaglutide. RESULTS: We found 47 patients who had taken oral semaglutide. Body weight significantly decreased at 3 and 6 months after the start of oral semaglutide, and systolic blood pressure significantly decreased after 6 months. Hemoglobin A1c (HbA1c) tended to decrease after 3 months and significantly deceased after 6 months. Serum low-density lipoprotein cholesterol (LDL-C) levels significantly decreased after 6 months and non-high-density lipoprotein-cholesterol (non-HDL-C) levels tended to decrease after 6 months. Urinary albumin to creatinine ratio (UACR) tended to decrease after 3 and 6 months. Such favorable metabolic changes by oral semaglutide were observed more prominently in patients who had not ever used GLP-1 analogues than in patients who switched from subcutaneous GLP-1 analogues. CONCLUSIONS: Our study showed that oral semaglutide improved body weight, blood pressure, HbA1c, LDL-C, non-HDL-C and UACR, in type 2 diabetic obese patients, especially, in patients who had not ever used GLP-1 analogues.