Semaglutide: A New Treatment for Diabetes and Weight Loss

Semaglutide is a very promising new drug for treating diabetes and obesity. This drug seems to be revolutionizing weight loss, capturing the attention of the medical community and the public. This article examines what semaglutide is, how it works, its health effects, and potential side effects and risks associated with using this “miracle” drug.

What is semaglutide?

Semaglutide is in a class of drugs known as glucagon-like peptide-1 receptor agonists (GLP-1 RA). It was initially developed for managing type 2 diabetes. However, GLP-1 is a hormone naturally produced by the intestines. It stimulates insulin secretion and reduces appetite. Therefore, semaglutide is a drug that mimics the actions of the natural hormone, GLP-1, by helping to reduce appetite and regulate blood sugar levels.

In 2017, the United States Food and Drug Administration (FDA) approved semaglutide for the treatment of type 2 diabetes.

In 2018, during the STEP (Semaglutide Treatment Effect in People with Obesity) trial, participants who received semaglutide lost an average of about 15% of their body weight over 68 weeks. The results were even better and lasted longer when combined with lifestyle changes like diet and exercise.

In 2021, after years of research and development, semaglutide was officially approved for an entirely different purpose — weight loss.

How it works

Semaglutide is different because it offers dual actions in both diabetes management and weight loss. This is mainly due to its unique mechanism of action.

It not only stimulates insulin secretion but also suppresses glucagon release, lowering blood sugar levels and helping treat diabetes. In addition, semaglutide affects the central nervous system, reducing appetite and promoting feelings of fullness.

By targeting both blood sugar control and appetite regulation, semaglutide addresses two critical factors in the management of obesity and diabetes. Semaglutide can be a powerful tool in both domains.

Beyond diabetes and weight loss

Researchers have documented the results and positive effects of semaglutide in treating obesity and type 2 diabetes. However, the once-a-week injection is proving to provide more benefits than simply helping curbing hunger pangs and regulating blood sugar levels.

• Improved blood sugar control. Semaglutide stimulates insulin secretion and suppresses glucagon release, effectively lowering blood sugar levels. When blood sugar is consistently balanced, it helps people with type 2 diabetes achieve better glycemic control, reducing HbA1c levels.
• Appetite control. Semaglutide's appetite-suppressing effects help people feel satisfied with smaller portions, making adhering to a lower-calorie diet easier.
• Weight loss. Excess weight is a common comorbidity in diabetes. The weight loss effect of semaglutide helps improve insulin sensitivity, reducing the need for more diabetes medications. This weight loss leads to improvements in other obesity-related health conditions, enhancing overall health and quality of life.
• Cardiovascular benefits. The American College of Cardiology reports that semaglutide has shown cardiovascular benefits, like a “statistically significant [20%] reduction in major adverse cardiovascular events (MACE) compared with placebo” groups.
• Psychological benefits. Improved health, lowered weight, and better blood sugar control often bring about positive psychological changes like improved self-esteem and reduced anxiety or depression related to these issues.

Who qualifies and how is it taken?

It is important to remember that semaglutide injections are not for everyone. To be eligible to take semaglutide, you must have a BMI of 30 or higher, be 18 years or older, and be willing to commit to regular medical appointments for monitoring while on the medication.

The most common administration of semaglutide is a once-weekly subcutaneous injection. Weekly treatment often reduces the burden of having to take daily medication. With less hassle, patient follow-through and compliance are often much higher compared to other drugs. The injection dose ranges from 0.5–2.5mg, depending on the specific type of semaglutide and the patient’s medical history and indications.

Side effects

Like with any medication, it’s important to consider the side effects and risks associated with taking semaglutide, as well as populations who should not be taking the drug.

The most common side effects and adverse reactions include:

Risks and precautions

Risks and precautions associated with taking semaglutide include:

• Acute kidney injury and worsening of chronic renal failure, sometimes requiring hemodialysis, has been seen in some people taking semaglutide. Watch for dehydration caused by vomiting and diarrhea-related fluid loss.
• Acute pancreatitis, which presents with persistent severe abdominal pain, sometimes radiating to the back, and which may or may not be accompanied by vomiting.
• The increase in the occurrence of acute gallbladder disease, including gallstones and cholecystitis, especially in children aged 12 years and older.
• Some users had reactions such as suicidal behavior and ideation. Users should discontinue use immediately if experiencing these symptoms.
• Semaglutide increases the risk of a racing heart rate. Users should discontinue use if experiencing a sustained increase in resting heart rate.
• Serious hypersensitivity reactions (like anaphylaxis and angioedema) have been reported in some people treated with semaglutide.
• If any of these signs, symptoms, or risks are experienced, immediately stop using semaglutide and seek professional medical care.
• Semaglutide use may lower blood sugar too much, causing hypoglycemia.
• Diabetic retinopathy complications in those with Type 2 Diabetes.
• Thyroid C-cell tumors.

Who shouldn't take semaglutide?

Semaglutide is contraindicated for:

• Children. Children over 12 years of age treated with semaglutide had greater incidences of rash, low blood pressure, gallstones, cholecystitis, and urticaria compared to adults treated with semaglutide.
• People with a personal or family history of MTC, MEN 2, prior serious hypersensitivity reaction to semaglutide (anaphylaxis and angioedema have been reported with semaglutide).
• Pregnancy. Discontinue semaglutide at least two months before a planned pregnancy.
• People with type 1 diabetes mellitus.

People taking medications should watch for interactions with semaglutide:

• Gastric emptying is delayed in those taking semaglutide, which could impact the absorption of oral medications, so be sure to monitor changes with your doctor.
• Those taking insulin secretagogues (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.

Semaglutide looks to be a very promising tool for individuals seeking effective solutions for both type 2 diabetes and weight loss. Proper education, close monitoring, and individualized treatment plans are crucial in harnessing the benefits of semaglutide while minimizing its risks and potential side effects. Contact a medical or healthcare professional to learn more.