The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes

ObjectiveGLP-1 receptor agonists (GLP-1 RAs) reduce cardiovascular events in type 2 diabetes (T2D), and oral formulations improve accessibility. However, their real-world effectiveness and predictors of response remain unclear. This study assessed the proportions of individuals achieving HbA1c &...

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Main Authors: Mizuki Ishiguro, Rimei Nishimura
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1615516/full
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author Mizuki Ishiguro
Rimei Nishimura
author_facet Mizuki Ishiguro
Rimei Nishimura
author_sort Mizuki Ishiguro
collection DOAJ
description ObjectiveGLP-1 receptor agonists (GLP-1 RAs) reduce cardiovascular events in type 2 diabetes (T2D), and oral formulations improve accessibility. However, their real-world effectiveness and predictors of response remain unclear. This study assessed the proportions of individuals achieving HbA1c < 7.0% and experiencing ≥3.0% weight reduction after 180 days of maintenance-dose therapy (no dose modification for ≥180 days).MethodsWe retrospectively analyzed 169 participants with T2D (3 mg: n=45; 7 mg: n=92; 14 mg: n=32) treated at a single medical care center in Japan. The cohort included participants with HbA1c ≥ 7.0% at baseline. We evaluated semaglutide changes in HbA1c and weight, and predictors of glycemic response after 180 days of maintenance therapy using logistic regression.ResultsBaseline characteristics included median age 63.0 years, body mass index (BMI) 27.2 kg/m², diabetes duration 10.0 years, and HbA1c 7.7%. Oral semaglutide was initiated as the first or second choice in 45.0% of participants. HbA1c < 7.0% was achieved in 60.0%, 53.3%, and 46.9% of the 3 mg, 7 mg, and 14 mg groups, respectively. Weight reduction ≥ 3.0% occurred in approximately half of participants across all groups. Lower baseline HbA1c (B = -1.330, p < 0.001) and earlier semaglutide use (first/second choice; B = 1.070, p = 0.013) were significant predictors of HbA1c < 7.0%.ConclusionApproximately 50% of participants across all dosing groups achieved HbA1c < 7.0% after 180 days of maintenance therapy. Weight reduction (≥ 3.0%) occurred frequently in parallel with HbA1c reduction. Early semaglutide use (first/second choice) and lower baseline HbA1c predicted HbA1c < 7.0% on maintenance therapy.
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spelling doaj-art-b6875c44904d47ff95757a0e42bf693f2025-08-26T04:13:08ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-08-011610.3389/fendo.2025.16155161615516The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetesMizuki IshiguroRimei NishimuraObjectiveGLP-1 receptor agonists (GLP-1 RAs) reduce cardiovascular events in type 2 diabetes (T2D), and oral formulations improve accessibility. However, their real-world effectiveness and predictors of response remain unclear. This study assessed the proportions of individuals achieving HbA1c < 7.0% and experiencing ≥3.0% weight reduction after 180 days of maintenance-dose therapy (no dose modification for ≥180 days).MethodsWe retrospectively analyzed 169 participants with T2D (3 mg: n=45; 7 mg: n=92; 14 mg: n=32) treated at a single medical care center in Japan. The cohort included participants with HbA1c ≥ 7.0% at baseline. We evaluated semaglutide changes in HbA1c and weight, and predictors of glycemic response after 180 days of maintenance therapy using logistic regression.ResultsBaseline characteristics included median age 63.0 years, body mass index (BMI) 27.2 kg/m², diabetes duration 10.0 years, and HbA1c 7.7%. Oral semaglutide was initiated as the first or second choice in 45.0% of participants. HbA1c < 7.0% was achieved in 60.0%, 53.3%, and 46.9% of the 3 mg, 7 mg, and 14 mg groups, respectively. Weight reduction ≥ 3.0% occurred in approximately half of participants across all groups. Lower baseline HbA1c (B = -1.330, p < 0.001) and earlier semaglutide use (first/second choice; B = 1.070, p = 0.013) were significant predictors of HbA1c < 7.0%.ConclusionApproximately 50% of participants across all dosing groups achieved HbA1c < 7.0% after 180 days of maintenance therapy. Weight reduction (≥ 3.0%) occurred frequently in parallel with HbA1c reduction. Early semaglutide use (first/second choice) and lower baseline HbA1c predicted HbA1c < 7.0% on maintenance therapy.https://www.frontiersin.org/articles/10.3389/fendo.2025.1615516/fullGLP-1 receptor agoniststype 2 diabetesoral antidiabetic drugssemaglutideHbA1c
spellingShingle Mizuki Ishiguro
Rimei Nishimura
The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes
Frontiers in Endocrinology
GLP-1 receptor agonists
type 2 diabetes
oral antidiabetic drugs
semaglutide
HbA1c
title The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes
title_full The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes
title_fullStr The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes
title_full_unstemmed The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes
title_short The impact of oral semaglutide on glycemic control and weight reduction: a database analysis of dosing effects in Japanese individuals with type 2 diabetes
title_sort impact of oral semaglutide on glycemic control and weight reduction a database analysis of dosing effects in japanese individuals with type 2 diabetes
topic GLP-1 receptor agonists
type 2 diabetes
oral antidiabetic drugs
semaglutide
HbA1c
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1615516/full
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