Semaglutide Significantly Reduces Long-Term Diabetes Risk Among Obesity Patients

According to new findings presented at the American Diabetes Association (ADA) 2022 Scientific Sessions this weekend, 2.4 mg of semaglutide once weekly is associated with an approximately 60% reduced risk of type 2 diabetes in obese patients.

In new, recent data presented by study author W. Timothy Garvey, MD, an endocrinologist and Butterworth Professor of Medicine in the Department of Nutritional Sciences at the University of Alabama School of Medicine, a team of US researchers found that the GLP-1 agonist significantly reduced a risk of developing type 2 diabetes in obese people, regardless of their glycemic baseline, when combined with diet and exercise.

The approval comes months after the U.S. Food and Drug Administration (FDA) streamlined the approval of Novo Nordisk’s 2.0 mg subcutaneous injection semaglutide (Ozempic) as a weekly treatment for adults with type 2 diabetes. The drug was previously indicated for reducing the risk of major cardiovascular events (MACE) in adults with both diabetes and cardiovascular disease.

Garvey, who revealed previous work with Novo Nordisk, and colleagues sought to assess the risk of type 2 diabetes associated with the 2.4 mg weekly dose in obese people using data from the pivotal STEP 1 and STEP 4 studies for semaglutide.

STEP 1 was a global, multicenter, double-blind, randomized, placebo-controlled study evaluating semaglutide (n = 1306) versus placebo (n = 655) for weight loss in overweight or obese patients without type 2 diabetes at baseline, over 68 weeks . STEP 4 was a 20-week run-in study of semgalutide in the same treatment population, with a randomized withdrawal assessment 48 weeks thereafter.

Researchers calculated a post-hoc 10-year type 2 diabetes risk among STEP 1 and 4 participants who received semaglutide using a Bayesian logistic regression of type 2 diabetes risk factors called Cardiometabolic Disease Staging (CMDS), which measured cardiometabolic risk at 5 levels of metabolic health ( stage 0) to present type 2 diabetes and cardiovascular disease (stage 4). Patients in STEP 1 in both treatment arms were stratified based on normoglycemia or prediabetes.

Of the STEP 1 patients with normoglycemia, patients receiving semaglutide reduced their geometric mean risk score for type 2 diabetes from 15.5% at baseline to 6.3% at week 68, compared to a decrease from 15.9% to 14. 2% in patients who received placebo. In patients with prediabetes, the semaglutide arm reduced mean diabetes risk from 22.4% at baseline to 8.3% at week 68, while the placebo arm only decreased from 21.5% to 18.3%.

Overall, patients treated with semaglutide in STEP 1 reduced mean risk scores for type 2 diabetes from 18.2% to 7.1% (61%), versus the placebo arm reduction of 17.8% up to 15.6% (13% risk reduction; p <.01).

In STEP 4, patients receiving semaglutide reported a baseline type 2 diabetes risk score of 20.6%. In the treated patients, the mean risk decreased to 11.4% at week 20 and then to 7.7% at week 68 after the withdrawal period. In patients who received placebo, the mean risk decreased to 10.7% at week 20, but then increased to 15.4% after withdrawal, indicating an overall reduction of 32% with semaglutide versus an increase of 41 % with placebo (p <.01).

Researchers noted that changes in risk score for type 2 diabetes were consistent with those of weight loss from the original STEP 1 and 4 study results.

“In summary, treatment with semaglutide reduces the 10-year risk of type 2 diabetes by approximately 60%, regardless of initial glycemic status, requiring long-term treatment to maintain this benefit,” they concluded. “These data suggest that semaglutide may help prevent type 2 diabetes in obese people.”

The study, “Semaglutide 2.4 mg reduces 10-year T2D risk in overweight/obese people”, was presented at ADA 2022

Leave a Comment

Your email address will not be published.