From the Guidelines
Vision Problems Associated with Semaglutide
The use of semaglutide, a glucagon-like peptide-1 receptor agonist, has been associated with an increased risk of developing vision problems, including diabetic retinopathy and potentially diabetic macular edema 1.
- Specifically, patients with a prior history of proliferative retinopathy may be at higher risk of worsening vision when taking semaglutide, particularly due to the rapid and sustained reductions in blood glucose observed with this medication 1.
- It is recommended that patients undergo a recent eye examination prior to semaglutide initiation, as per current guidelines 1.
- The increased risk of diabetic retinopathy complications with semaglutide is hypothesized to be related to its efficacy in rapidly reducing blood glucose and A1C levels 1.
- Therefore, regular monitoring of vision and guideline-recommended eye examinations are crucial for patients taking semaglutide, especially those with a history of diabetic retinopathy 1.
From the FDA Drug Label
In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with OZEMPIC (3.0%) compared to placebo (1. 8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline (OZEMPIC 8.2%, placebo 5.2%) than among patients without a known history of diabetic retinopathy (OZEMPIC 0.7%, placebo 0. 4%). Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy. Inform patients to contact their physician if changes in vision are experienced during treatment with OZEMPIC [see Warnings and Precautions (5. 3)].
The vision problems associated with semaglutide are diabetic retinopathy complications. Patients with a history of diabetic retinopathy are at a higher risk and should be monitored for progression of the disease. Patients should also be informed to contact their physician if they experience any changes in vision during treatment with semaglutide 2.
From the Research
Vision Problems Associated with Semaglutide
- Diabetic retinopathy (DR) is a vision problem associated with semaglutide, as indicated by an increase in DR events in the SUSTAIN 6 trial 3, 4
- Patients at risk for deterioration of existing diabetic retinopathy should be carefully monitored if treated with semaglutide, particularly if also treated with insulin 5
- The risk for diabetic retinopathy complications (DRCs) is higher with semaglutide, as seen in the SUSTAIN 6 trial, which is the first instance of a GLP-1 RA demonstrating significantly increased risk for DRCs 4