Semaglutide is an injectable medication used to improve glycemic control in adults with type 2 diabetes. It is in a class of medications called GLP-1 receptor agonists which work by stimulating the release of insulin and decreasing glucagon secretion.
Some key benefits of Semaglutide therapy include:
Semaglutide was approved by the FDA in 2019 under the brand names Ozempic® and Rybelsus®.
Semaglutide is a glucagon-like peptide-1 (GLP-1) analogue that activates the GLP-1 receptor, stimulating the release of insulin only when blood glucose levels are elevated. This glucose-dependent mechanism of action results in a low risk of hypoglycemia.
Some of the beneficial effects of GLP-1 receptor activation include:
Semaglutide may be an appropriate treatment option for adults with type 2 diabetes who:
Semaglutide can be used alone or added to other diabetes medications. It may also be an alternative for patients who cannot tolerate or have contraindications for other injectable GLP-1 receptor agonists.
Table 1. Patient criteria for Semaglutide therapy
| Qualifying Hemoglobin A1c | Body Mass Index | Concurrent Diabetes Medications |
|---|---|---|
| ≥ 7.0% | ≥ 25 kg/m2 | Metformin, SGLT2 inhibitors, sulfonylureas, basal insulin |
The recommended starting dose of semaglutide is 0.25 mg injected subcutaneously once weekly. The dose can be increased to 0.5 mg once weekly after 4 weeks, then to a target maintenance dose of 1 mg once weekly. Semaglutide should be taken on the same day each week.
Patients starting semaglutide should have A1C, kidney function, and electrolytes monitored at least every 6 months. Signs and symptoms of pancreatitis should also be assessed.
Table 2. Timeline for dose titration and monitoring
| Week | Dose | Monitoring |
|---|---|---|
| 0 | 0.25 mg | Kidney function, electrolytes |
| 4 | Increase to 0.5 mg | Assess GI side effects |
| 8 | Increase to 1 mg | Check A1C |
| 24 | 1 mg | Check A1C, kidney function |
Semaglutide has demonstrated clinically significant improvements in glycemic control and body weight.
In clinical trials, semaglutide lowered A1C by 1.5-1.8% on average when added to 1-2 other diabetes medications. Up to 3 out of 4 patients achieving an A1C below 7%.
Reductions were seen across groups including:
Significant decreases in fasting and postmeal glucose were also observed.
Most patients treated with semaglutide lost weight, with average losses of 10-15 pounds. Up to 2 out of 3 patients losing at least 5% of their body weight.
This weight loss was maintained up to 2 years, leading to sustained cardiometabolic benefits.
In the large SUSTAIN 6 trial, semaglutide significantly reduced:
It also slowed the progression of diabetic kidney disease by 36% compared to placebo.
The most common side effects of semaglutide are gastrointestinal in nature due to the effects of GLP-1 receptor activation. They are usually mild to moderate and decrease over time.
| Side Effect | Prevalence | Management |
|---|---|---|
| Nausea | 10-40% | Take with food or at night, slower titration |
| Vomiting | 5-15% | Slower titration, antiemetics |
| Diarrhea | 5-15% | Hydration, over-the-counter treatments |
| Decreased appetite | 5-10% | Expected effect for weight loss |
| Abdominal pain | 5-10% | Rule out pancreatitis |
Rare but serious side effects requiring prompt medical care include:
Thyroid C-cell tumors are a theoretical risk but have not been observed with semaglutide treatment durations under 2 years.
"After struggling with weight loss for over a decade, I finally succeeded after starting semaglutide. I've lost 38 pounds and my A1C dropped from 9.1% to 5.9% in only 9 months. My energy levels are way up and I've been able to stop 2 of my medications. I wish I had tried this years ago!" – Sarah Johnson
Making healthy lifestyle changes can enhance the effectiveness of semaglutide therapy. We recommend patients work on the following areas:
"I was nervous to try injectable medication, but the Ozempic pen is very easy to use. I barely feel the tiny needle. Staying active on this medication kept my energy levels high. After losing 25 pounds and getting my A1C to 6.2%, all my initial hesitations were put at ease. I feel better than I have in years!" – Michael Brown
At Balance Hormones Clinic, we specialize in cutting edge type 2 diabetes care including semaglutide and other innovative treatments. Our compassionate providers partner with patients using a personalized, evidence-based approach focusing on safety and achieving treatment goals.
We perform comprehensive lab testing, diabetes education programs, and lifestyle counseling. Patients have access to certified diabetes care and education specialists, dietitians, and mental health professionals.
Convenient telemedicine visits allow patients across the state to access our services. We accept most major insurance plans. Uninsured patients can discuss cash pricing options.
"As a busy mom of 3 kids, I struggled to prioritize my health. My primary care doctor just kept increasing doses of medications and nothing really worked. The compassionate staff at Balance Hormones Clinic took the time to understand my needs. In just one visit I left feeling empowered with a treatment plan I could realistically integrate into my lifestyle. I'm so grateful to have found them!" – Jessica Davis
Conclusion: Semaglutide is a highly effective medication for improving glycemic control and promoting weight loss in adults with type 2 diabetes. When combined with healthy lifestyle changes, it can provide sustained benefits for managing diabetes and reducing cardiovascular and kidney disease risk. At Balance Hormones Clinic, our experienced providers offer personalized semaglutide treatment plans along with comprehensive diabetes care and support services.
