Efficacy of Oral Semaglutide after Switching from DPP-4 Inhibitors on Glucose Level and Body Weight Control in Japanese Type 2 Diabetes Patients with Obesity

Abstract

Background and Objective : Although oral semaglutide may be considered as a suitable treatment option for obese patients with type 2 diabetes mellitus (T2DM) inadequately responsive to dipeptidyl peptidase (DPP)-4 inhibitor–based therapy, evidence from actual clinical settings remains limited. This study aimed to investigate the effect of oral semaglutide in obese patients with T2DM who had an inadequate response to DPP-4 inhibitor–based therapy. Methods: This study was a retrospective, single-center study in which outpatients with T2DM were 1) aged 20 years or older at the time of oral semaglutide administration, 2) treated with an existing DPP-4 inhibitor for 3 months and/or longer at the time of oral semaglutide administration, and 3) had a hemoglobin A1c (HbA1c) level of ≥ 6.5% and/or a body mass index (BMI) ≥ 25.0 kg/m 2 . The primary endpoints were changes in HbA1c and body weight from baseline to 6 months after oral semaglutide treatment switching from DPP-4 inhibitor. Results: In the 48 patients studied, HbA1c was 7.01 ± 0.54%, and BMI was 26.7 ± 3.6 kg/m 2 at baseline. HbA1c significantly decreased by 0.68 ± 0.36%, and body weight significantly decreased by 3.4 ± 2.3 kg (p < 0.001 for each). Improvements in indices of lipid metabolism and liver function were observed. Non-serious nausea and loss of appetite were observed in many patients, but these symptoms resolved in approximately 3 months. Mild constipation was also observed. Conclusion: Oral semaglutide appears to be a promising alternative to DPP-4 inhibitors as a means of glycemic and weight control in obese T2DM.