Sven Wombwell
Article by: Sven Wombwell
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Quick summary
Semaglutide is a medication that belongs to a class of drugs called GLP-1 receptor agonists. It works by mimicking the effects of a hormone called glucagon-like peptide-1 (GLP-1) in the body, which helps to regulate blood sugar levels, reduces appetite, and promotes weight loss. Semaglutide is used to treat type 2 diabetes and obesity, and is typically administered once weekly, or as a daily sublingual pill. Studies show it effectively reduces the risk of cardiovascular events in people with type 2 diabetes and helps people with obesity lose weight.

What is Semaglutide?

Semaglutide is a popular, high-profile drug that seems to be talked about everywhere, from the red carpets of Hollywood to the pages of magazines worldwide. It may be the height of fashion, but semaglutide appears to have earned its place on the front page. It's proving to be a wonder drug for aiding weight loss and treating type 2 diabetes. So, Let's take a closer look at "How does semaglutide work?"

Semaglutide is an incredibly effective medication for treating type 2 diabetes and obesity. Belonging to a class of drugs called GLP-1 receptor agonists, semaglutide mimics the effects of the hormone glucagon-like peptide-1 (GLP-1). Semaglutide stimulates the release of insulin, which helps to lower blood sugar levels and also helps to regulate appetite and food intake.

How Does Semaglutide Work?

Semaglutide binds to GLP-1 receptors in the body, having several significant health benefits.

Here are a few of the ways that semaglutide works:

  1. Increases Insulin Secretion: Semaglutide stimulates insulin release from the pancreas, which helps reduce blood sugar levels. Lower blood sugar levels can benefit people with type 2 diabetes, who may have difficulty producing enough insulin.
  2. Slows Gastric Emptying: Semaglutide also slows down the rate at which food leaves the stomach and enters the small intestine. It helps regulate your appetite and reduce food intake, leading to weight loss.
  3. Reduces Glucagon Secretion: Semaglutide also reduces the amount of glucagon released by the pancreas. Glucagon is a hormone that raises blood sugar levels. So, reducing its release can help control blood sugar levels.
  4. Increases Satiety: Semaglutide increases feelings of fullness and reduces hunger, which can also lead to weight loss.

"It is, without a doubt, one of the most promising drugs in the field of diabetes and obesity"

Dr. Daniel Drucker, a professor of medicine at the University of Toronto, on the potential of semaglutide to revolutionize diabetes treatment. (Source: The Globe and Mail)

What Types of Semaglutide Are Available?

Semaglutide comes in three different forms: a daily and weekly injection and a sublingual troche that dissolves under the tongue. The daily injection is administered beneath the skin using a prefilled pen, and the weekly injection is also given under the skin with a prefilled pen. It's essential to recognize that all forms of semaglutide are prescription medications and should be utilized only under the supervision of a healthcare provider.

There are currently four types of semaglutide available in the market:

  1. Injectable Semaglutide for type 2 diabetes: A once-weekly injection designed to enhance glycemic control in adults with type 2 diabetes. It also diminishes the risk of major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease.
  2. Injectable Semaglutide for Weight Management (semaglutide injection): This is another once-weekly injection for chronic weight management in adults with obesity or overweight who have at least one weight-related condition.
  3. Oral Semaglutide: This once-daily pill improves glycemic control in adults with type 2 diabetes. It is the first and only oral GLP-1 receptor agonist approved in the United States. It works by mimicking the effects of the hormone GLP-1, which helps to regulate blood sugar levels, reduce appetite, and promote weight loss.
  4. Sublingual Semalglutide Pills: Once-daily troche dissolves quickly under the tongue and is as effective as the others in this list. There is no need for a weekly injection; they are easier to titrate up or down, convenient, and easy to take. One advantage is these avoid the peaks and valleys you get with injections, meaning fewer side effects.

What Benefits Does Semaglutide Have

"The most impressive results we've seen in diabetes in decades"

Dr. Robert Courgi, an endocrinologist, discussing semaglutide's ability to reduce HbA1c levels and promote weight loss. (Source: MedPage Today)

Semaglutide has several benefits, making it a valuable medication for treating type 2 diabetes and obesity. Here are some of the key benefits of semaglutide:

  1. Lowering blood sugar levels: Semaglutide works by mimicking the effects of the hormone GLP-1, which stimulates insulin release from the pancreas, leading to lower blood sugar levels.
  2. Reducing appetite: Semaglutide also works by reducing appetite and increasing feelings of fullness, which can help people with obesity to lose weight.
  3. Promoting weight loss: Semaglutide is highly effective in promoting weight loss in people with obesity, with clinical studies showing an average weight loss of around 15% of body weight over a 68-week period. People who took the drug lost an impressive average of 15.3 pounds over 68 weeks, compared to 2.6 pounds in the placebo group. [1] [2]
  4. Reducing the risk of cardiovascular events: Semaglutide significantly reduces the risk of major cardiovascular events, such as heart attack or stroke, in people with type 2 diabetes who are at high risk of these events. [3]
  5. Improving overall health: Besides its effects on blood sugar levels and weight, semaglutide has other health benefits, such as reducing inflammation and improving liver function. [4]

Stats and Studies on Semaglutide

In 2020, The US Food and Drug Administration (FDA) approved semaglutide to treat obesity and type 2 diabetes. It is the first medication for chronic weight management to be approved in the US in nearly a decade.

Several studies explore "How does semaglutide work?" and its effectiveness. Here are a few of the key studies:

  1. The SUSTAIN 6 trial: This trial looked at the effectiveness of semaglutide in reducing the risk of major cardiovascular events in people with type 2 diabetes. The trial found that semaglutide reduced the risk of major cardiovascular events by 26% compared to a placebo.
  2. The STEP 1 trial: This trial looked at the effectiveness of semaglutide in treating obesity. The trial found that people who took semaglutide lost significantly more weight than those who took a placebo, with an average weight loss of 14.9% compared to 2.4% for the placebo group.
  3. The PIONEER 3 trial: This trial looked at how effective semaglutide is in treating type 2 diabetes. The trial found that people who took semaglutide had significantly reduced HbA1c (a measure of blood sugar levels) compared to those who took a placebo.

It's important to note that semaglutide is not a magic solution for type 2 diabetes or obesity. However, when combined with a TRT, healthy diet and exercise, the results can be life-changing.

"Semaglutide's effectiveness and safety in the reduction of cardiovascular events and mortality in people with type 2 diabetes is remarkable."

Dr. Julio Rosenstock, a principal investigator in a clinical trial of semaglutide, commenting on the drug's ability to reduce the risk of major cardiovascular events. (Source: Endocrine Today)

Does Semaglutide Have Any Side Effects?

Semaglutide is generally well-tolerated but can cause side effects like any medication. Common side effects include nausea, vomiting, diarrhea, and constipation. These side effects usually disappear after a few days or weeks of treatment. In rare cases, semaglutide can cause more severe side effects, such as pancreatitis, gallbladder disease, or kidney problems. Talking to your healthcare provider if you experience any unusual symptoms while taking semaglutide is important.

How Does Semaglutide Work? The Answer is - Very Well!

"It's a game-changer. It's the first time that we've seen a drug that not only lowers blood sugar, but also reduces the risk of cardiovascular disease and helps people lose weight"

Dr. Rachel Batterham, a professor of obesity, diabetes, and endocrinology.

Overall, semaglutide is an important medication for treating type 2 diabetes and obesity. Studies show it effectively lowers blood sugar levels and promotes weight loss. This drug may also benefit conditions like cardiovascular disease and Alzheimer's disease.

However, like any medication, semaglutide should only be used under a health provider's guidance and with the right lifestyle changes to maximize its benefits. Patients should also be aware of the potential side effects and risks. If you are considering semaglutide as a treatment option, talk to your healthcare provider to determine if it's right for you.

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References
[1] Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
[2] Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
[3] Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
Steven P. Marso, M.D., Stephen C. Bain, M.D., Agostino Consoli, M.D., Freddy G. Eliaschewitz, M.D., Esteban Jódar, M.D., Lawrence A. Leiter, M.D., Ildiko Lingvay, M.D., M.P.H., M.S.C.S., Julio Rosenstock, M.D., Jochen Seufert, M.D., Ph.D., Mark L. Warren, M.D., Vincent Woo, M.D., Oluf Hansen, M.Sc., et al., for the SUSTAIN-6 Investigators*
[4] Ryan DH, Lingvay I, Colhoun HM, Deanfield J, Emerson SS, Kahn SE, Kushner RF, Marso S, Plutzky J, Brown-Frandsen K, Gronning MOL, Hovingh GK, Holst AG, Ravn H, Lincoff AM. Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) rationale and design. Am Heart J. 2020 Nov;229:61-69. doi: 10.1016/j.ahj.2020.07.008. Epub 2020 Jul 17. PMID: 32916609.
Others
Davies, M. J., Bergenstal, R., Bode, B., et al. (2017). Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA, 317(3), 241–254. doi: 10.1001/jama.2016.20024.
Davies, M. J., Bain, S. C., Atkin, S. L., et al. (2019). Efficacy and Safety of Semaglutide Once Weekly Versus Sitagliptin Once Daily as an Add-On to Metformin, Thiazolidinediones, or Both, in Patients With Type 2 Diabetes (SUSTAIN 2): A 56-Week, Double-Blind, Phase 3a, Randomized Trial. Diabetes Care, 42(4), 684-693. doi: 10.2337/dc18-1443.
Novo Nordisk. (2020). Novo Nordisk Annual Report 2020. Retrieved from https://www.novonordisk.com/content/dam/Denmark/HQ/aboutus/investors/annual-report-2020/pdf/Novo-Nordisk-AR20.pdf.
US Food and Drug Administration. (2020). FDA Approves New Weight Management Drug. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-weight-management-drug.
Husain, M., Birkenfeld, A. L., Donsmark, M., et al. (2019). Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. New England Journal of Medicine, 381(9), 841-851. doi: 10.1056/NEJMoa1901118.
Rosenstock J, Allison D, Birkenfeld AL, et al. Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. JAMA. 2019;321(15):1466–1480. doi:10.1001/jama.2019.2942
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