Alkhalifah M, Afsar H, Shams A, Blaibel D, Chandrabalan V, Pappachan JM. Semaglutide for the management of diabesity: The real-world experience. World J Methodol 2024; 14(3): 91832 [PMID: 39310241 DOI: 10.5662/wjm.v14.i3.91832]
Corresponding Author of This Article
Joseph M Pappachan, MD, FRCP, Academic Editor, Consultant Endocrinologist, Professor, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Sharoe Green Lane, Preston PR2 9HT, United Kingdom. drpappachan@yahoo.co.in
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Methodol. Sep 20, 2024; 14(3): 91832 Published online Sep 20, 2024. doi: 10.5662/wjm.v14.i3.91832
Semaglutide for the management of diabesity: The real-world experience
Mohammed Alkhalifah, Hafsa Afsar, Anindya Shams, Dania Blaibel, Vishnu Chandrabalan, Joseph M Pappachan
Mohammed Alkhalifah, Hafsa Afsar, Anindya Shams, Dania Blaibel, Joseph M Pappachan, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
Mohammed Alkhalifah, Department of Family Medicine, King Faisal Specialist Hospital, Riyadh 11211, Saudi Arabia
Vishnu Chandrabalan, Department of Data Science, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
Joseph M Pappachan, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester M13 9PL, United Kingdom
Author contributions: Alkhalifah M, Afsar H and Shyams A collected the clinical data. Alkhalifah M, Shyams A and Blaibel D performed literature search, and interpretation of relevant data following statistical analysis; Alkhalifah M, Blaibel D, and Chandrabalan V contributed to the work with additional literature review and revision of the article critically for important intellectual content; Chandrabalan V also procured the patient data from the hospital electronic records; Pappachan JM contributed to the conceptual design of the paper and critically supervised the whole drafting, literature review, revision and modifications of the paper including figure construction and is the final author; All authors have read and approved the final version of the manuscript.
Institutional review board statement: The study-related audit was approved by the Institutional Audit Department.
Informed consent statement: This study is only a retrospective cohort study based on electronic case note review and therefore, patient consent is not necessary as per the standard publishing guidelines.
Conflict-of-interest statement: Authors have no conflicts of interests to declare.
Data sharing statement: Authors are happy to share the data on request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joseph M Pappachan, MD, FRCP, Academic Editor, Consultant Endocrinologist, Professor, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Sharoe Green Lane, Preston PR2 9HT, United Kingdom. drpappachan@yahoo.co.in
Received: January 6, 2024 Revised: January 29, 2024 Accepted: March 1, 2024 Published online: September 20, 2024 Processing time: 170 Days and 19.1 Hours
Abstract
BACKGROUND
Diabesity (diabetes as a consequence of obesity) has emerged as a huge healthcare challenge across the globe due to the obesity pandemic. Judicious use of antidiabetic medications including semaglutide is important for optimal management of diabesity as proven by multiple randomized controlled trials. However, more real-world data is needed to further improve the clinical practice.
AIM
To study the real-world benefits and side effects of using semaglutide to manage patients with diabesity.
METHODS
We evaluated the efficacy and safety of semaglutide use in managing patients with diabesity in a large academic hospital in the United States. Several parameters were analyzed including demographic information, the data on improvement of glycated hemoglobin (HbA1c), body weight reduction and insulin dose adjustments at 6 and 12 months, as well as at the latest follow up period. The data was obtained from the electronic patient records between January 2019 to May 2023.
RESULTS
106 patients (56 males) with type 2 diabetes mellitus (T2DM), mean age 60.8 ± 11.2 years, mean durations of T2DM 12.4 ± 7.2 years and mean semaglutide treatment for 2.6 ± 1.1 years were included. Semaglutide treatment was associated with significant improvement in diabesity outcomes such as mean weight reductions from baseline 110.4 ± 24.6 kg to 99.9 ± 24.9 kg at 12 months and 96.8 ± 22.9 kg at latest follow up and HbA1c improvement from baseline of 82 ± 21 mmol/mol to 67 ± 20 at 12 months and 71 ± 23 mmol/mol at the latest follow up. An insulin dose reduction from mean baseline of 95 ± 74 units to 76.5 ± 56.2 units was also observed at the latest follow up. Side effects were mild and mainly gastrointestinal like bloating and nausea improving with prolonged use of semaglutide.
CONCLUSION
Semaglutide treatment is associated with significant improvement in diabesity outcomes such as reduction in body weight, HbA1c and insulin doses without major adverse effects. Reviews of largescale real-world data are expected to inform better clinical practice decision making to improve the care of patients with diabesity.
Core Tip: Rational medical management of diabesity, i.e., diabetes resulting from obesity, involves judicious use of antidiabetic drugs which should ideally help body weight loss while controlling hyperglycemia. Although semaglutide use has been associated with significant improvements in body weight and glycated hemoglobin (HbA1c) in multiple randomized controlled trials (RCTs) and prospective observational studies, more real-world data from day-to-day medical practice would inform better clinical decision making. We report our retrospective study data that reveals better diabesity outcomes compared to RCTs with a mean weight loss of 12.3%, HbA1c reduction of 13.7% and insulin dose reduction of 19.5% with semaglutide treatment.
