Effectiveness of Weekly Semaglutide Treatment (0.5 or 1 mg) in Chilean Patients with Type 2 Diabetes Mellitus.

UNLABELLED: Semaglutide is approved in Chile for the management of type 2 diabetes mellitus (T2DM), although it is generally not available in the public health system. Generating local evidence may aid in its incorporation into national guidelines and reduce the therapeutic gap with international standards. AIM: To evaluate the effectiveness and safety of adding weekly semaglutide to the standard treatment for T2DM in the public health system. METHODS: A phase 4, multicenter, interventional study evaluated the weekly addition of 0.5 or 1 mg of subcutaneous semaglutide over 24 weeks, followed by a 5-week post-treatment monitoring period. RESULTS: n=104 (79.8% women; age: 58.3±9.3 years; 44.2% over 60 years of age; 35.6% with ≥1 complication of T2DM). Common comorbidities: hypertension: 71.2%; obesity: 71.2%; dyslipidemia: 51.9%. Most commonly used baseline treatments: metformin, 96.2%; NPH insulin, 65.4%; empagliflozin, 46.2%; regular insulin, 27.9%; insulin glargine, 22.1%; dapagliflozin, 21.2%. At 24 weeks, a reduction in glycosylated hemoglobin (HbA1c: 8.6±0.7% to 7±1%, difference: -1.6%), fasting blood glucose (160.3±49.3 to 133.7±54.8 mg/dL, difference: -26.2 mg/dL), and weight (89.3±20.2 to 85.3±20.4 kg; difference: -4 kg) were confirmed. Participants with HbA1c <7% increased from 0% to 56.4%. Thirty-one percent of patients receiving basal insulin reduced their dose (median: 6 IU). Gastrointestinal adverse events were the most frequent, consistent with the drug's safety profile. CONCLUSIONS: In people with inadequately controlled T2DM in the real world, the addition of a weekly dose of semaglutide was associated with improvement in HbA1c, fasting blood glucose, and weight, and a reduction in insulin dose, with an adequate safety profile. These results provide local evidence on the efficacy of semaglutide in improving various cardio-renal-metabolic risk factors in people with T2DM.