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An approved diabetes drug has now been shown to also help diabetic patients lose an average of 10% of their body weight, UT Southwestern reports in a landmark international study.
Semaglutide, an injectable medication taken once a week, offers a non-surgical way to reduce weight and treat obesity. It could help the more than 70 million adults in the United States battling this chronic disease, says Ildiko Lingvay, MD, MPH, MSCS, professor of internal medicine and population and data sciences at UTSW and lead author of the study, published today. in The Lancet.
People with diabetes benefit greatly from weight loss, but they have a much harder time losing weight than people without diabetes, Lingvay says. This study is the first to assess the weight loss effect of this drug exclusively in patients with type 2 diabetes.
This multicenter study was carried out at 149 sites in 12 countries in North America, Europe, South America, the Middle East, South Africa and Asia from June 2018 to June 2020. It is the ‘one of the studies conducted as part of the Semaglutide Treatment Effect. for people (STEP) with obesity program.
In the four clinical trials completed to date, people treated with this drug have lost an average of 10 to 17% of their body weight, which is a huge step forward compared to all other drugs currently available to treat it. obesity. With this drug, the results are close to what we see with bariatric surgery, which is 20-30% weight loss. “
Ildiko Lingvay, MD, MPH, MSCS, Professor of Internal Medicine and Population and Data Sciences, UT Southwestern Medical Center
Drugs in this class of drugs have been used for over a decade to treat people with diabetes. Semaglutide is currently approved by the Food and Drug Administration to lower blood sugar in people with diabetes at a dose of 0.5 mg or 1 mg once a week. The FDA is evaluating the use of a higher weekly dose of 2.4 mg for chronic weight management.
The STEP 2 study, a randomized, double-blind, double-dummy, placebo-controlled phase 3 clinical trial, reported in The Lancet, involved more than 1,200 adults with type 2 diabetes who were overweight or obese at the time. For 68 weeks, they injected semaglutide or a placebo once a week. A body mass index (BMI) greater than 30 or a BMI greater than 27 as well as other comorbidities were required to participate.
“In this study, more than a quarter of the participants lost more than 15% of their body weight, which is by far the best result we have had with any weight loss drug in diabetic patients,” says- she.
Other STEP trials of a 2.4 mg weekly dose of semaglutide in obese adults without diabetes reported even greater weight loss of 15 to 16 percent of body weight.
The drug works by suppressing appetite centers in the brain to reduce calorie intake, Lingvay adds.
“The medicine continually tells the body that you have just eaten, that you are full,” she says.
Participants took the subcutaneous injection with a pre-filled pen and a small needle once a week. They also met with a registered dietitian to help them follow a reduced calorie meal plan.
The average weight loss among participants treated with 2.4 mg of semaglutide was 21.4 pounds, compared with 7.7 pounds in the placebo group. About 69% of participants treated with semaglutide 2.4 mg lost 5% or more of their body weight, which may improve comorbidities such as high blood pressure. Half of the people taking 2.4 mg of semaglutide achieved weight loss of 10% or more, and 25% achieved weight loss of 15% or more.
For someone with diabetes, losing weight can be especially difficult.
“People with diabetes lose much less weight than their peers without diabetes,” says Lingvay. “For people with diabetes, 10 percent weight loss is a phenomenal accomplishment.”
The drug is recommended for lifelong use and is not meant to be stopped once weight loss is achieved, she adds.
“Obesity is a chronic disease,” says Lingvay. “It’s not something you treat like the flu.”
The side effects, including nausea, vomiting, and diarrhea, were mostly mild and very few people stopped taking the drug because of them.
Source:
UT Southwestern Medical Center
Journal reference:
Davies, M., et al. (2021) Semaglutide 2 4 mg once weekly in overweight or obese adults with type 2 diabetes (STEP 2): a randomized, double-blind, double-dummy, placebo-controlled phase 3 trial. The Lancet. doi.org/10.1016/S0140-6736(21)00213-0.
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