From the Research
Semaglutide significantly improves cardiovascular outcomes in patients with type 2 diabetes, as demonstrated in the most recent and highest quality study, the SOUL randomized trial 1. This study showed that oral semaglutide reduced the risk of major adverse cardiovascular events (MACE) by 14% compared to placebo over a mean follow-up of 47.5 months. The primary composite outcome included cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Notably, the reduction in MACE was consistent regardless of concomitant use of sodium-glucose co-transporter-2 inhibitors (SGLT2i). Patients taking semaglutide also experienced significant weight loss and improved glycemic control compared to placebo. Common side effects included gastrointestinal symptoms like nausea, vomiting, and diarrhea, which typically diminished over time. The cardiovascular benefits of semaglutide are believed to result from multiple mechanisms, including improved glycemic control, weight reduction, decreased blood pressure, improved lipid profiles, and potential direct effects on the cardiovascular system. These findings support using semaglutide not only for glycemic control but also for cardiovascular risk reduction in patients with type 2 diabetes who have established cardiovascular disease or are at high risk, as recommended by current guidelines 2. Key points to consider when prescribing semaglutide include:
- Its efficacy in reducing MACE, as demonstrated in the SOUL trial 1
- Its safety profile, which is similar to that of other GLP-1 receptor agonists 3, 4, 5
- Its potential for use in combination with SGLT2i, as shown in the SOUL trial 1
- Its importance in the treatment paradigm for type 2 diabetes, as outlined in current guidelines 2