Profile of semaglutide in the management of type 2 diabetes: design, development, and place in therapy

Abstract

Type 2 diabetes mellitus (T2DM) has become one of the leading causes of morbidity and mortality in developed countries. Low efficacy, weight gain, and hypoglycemia are the main pitfalls of previous treatments for T2DM. New therapies have been designed with the aim of improving the results in efficacy and quality of life. Glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1 RA) increase glucose-dependent insulin secretion, decrease gastric emptying, and reduce postprandial glucagon secretion. The last GLP-1 RA approved by the US Food and Drug Administration and European Medicines Agency was semaglutide. This review describes its pharmacology, core clinical data coming from the randomized controlled trials included in the development program, proven cardiovascular benefits, safety issues, and precautions for the use of semaglutide in special populations. Additionally, an overview of the positioning of semaglutide in T2DM therapy and practical issues regarding semaglutide initiation are offered.

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Keywords:

• semaglutide
• type 2 diabetes
• pharmacological treatment
• safety
• clinical practice

Acknowledgments

No funding or sponsorship was received for publication of this article. No writing assistance was obtained in the preparation of this manuscript.

Disclosure

Fernando Gomez-Peralta has received research support from Sanofi, Novo Nordisk, Boehringer Ingelheim, and Eli Lilly, has taken part in advisory boards for Sanofi, Novo Nordisk, and AstraZeneca Pharmaceuticals LP, and has acted as a speaker for Sanofi, Novo Nordisk, Boehringer Ingelheim, Novartis, Bristol-Myers Squibb Company, Eli Lilly, and AstraZeneca Pharmaceuticals LP. Cristina Abreu has received research support from Sanofi, Novo Nordisk, Boehringer Ingelheim Pharmaceuticals, and Lilly, and has acted as a speaker for Sanofi, Novo Nordisk, Boehringer Ingelheim Pharmaceuticals, AstraZeneca Pharmaceuticals LP, and Bristol-Myers Squibb Co. The authors report no other conflicts of interest in this work.

Author contributions

Both authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.