Weekly injections of the new obesity drug semaglutide could lower the risk of diabetes in patients, according to new research being presented at the European Association for the Study of Diabetes in Stockholm (19-23 Sept).
Semaglutide has recently been approved in the USA as an obesity treatment and has used been provisionally in England. Research has shown that the drug could halve the risk of type 2 diabetes.
“Semaglutide appears to be the most effective medication to date for treating obesity and is beginning to close the gap with the amount of weight loss following bariatric surgery,” said Dr W Timothy Garvey, of the Department of Nutrition Sciences, University of Alabama at Birmingham, who led the research.
“Its approval was based on clinical trial results showing that it reduces weight by over 15% on average, when used together with a healthy lifestyle programme. This amount of weight loss is sufficient to treat or prevent a broad array of obesity complications that impair health and quality of life and is a game changer in obesity medicine.”
Obesity drastically increases the risk of diabetes
People who are obese are six times more likely to be diagnosed with type 2 diabetes. Dr Garvey and the team were interested in whether semaglutde could reduce the risk of diabetes. The researcher’s analysed data from two trials of semaglutide.
In the first trial, known as STEP1, 1,961 participants with overweight or obesity received either a 2.4mg injection of semaglutide or a placebo for 68 weeks.
The second trial, known as STEP4, involved 803 participants with obesity or overweight. Every participant received weekly 2.4mg injections of semaglutide for 20 weeks. For the next 48 weeks, each participant either remained on semaglutide or was switched to a placebo. Participants also received advice on health and diet alongside the trial.
The researchers used Cardiometabolic Disease Staging (CMDS) to assess the participant’s risk of diabetes over the next ten years. CMDS has been shown to be a highly accurate measure of type 2 diabetes risk. CMDS considers the patient’s sex, age, race blood pressure, BMI, as well as HDL cholesterol and triglyceride levels.
Semaglutide use proved successful
In STEP1, participants receiving semaglutide had their ten-year risk of type 2 diabetes deceased by 61%, Those who received the placebo saw a reduction of 13% in risk score. The drop in risk score mirrored weight loss, the average loss in weight was 17% with semaglutide and 3% with the placebo.
In STEP4, the largest decrease in risk of diabetes scores was seen in the first 20 weeks (from 20.6% at week 0 to 11.4% at week 20). For those who continued to receive semaglutide the risk of diabetes score decreased by a further 7.7% but rose to 15.4% in those who were switched to the placebo.
These results indicate that sustained use of semaglutide is needed to maintain the reduction in the risk of diabetes.
“Semaglutide reduces the future risk of diabetes by over 60% in patients with obesity – this figure is similar whether a patient has prediabetes or normal blood sugar levels. Sustained treatment is required to maintain the benefit. Given the rising rates of obesity and diabetes, semaglutide could be used effectively to reduce the burden of these chronic diseases,” concluded Dr Garvey.
