1. Diabetes
FDA approved semaglutide after a series of successful trials called SUSTAIN (Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes). These trials played an important role in establishing the dose of semaglutide for type 2 diabetes. It is important to note that these trials are still ongoing and currently semaglutide is in phase 3.
The most recent SUSTAIN trial was published in 2022. It found that weekly administration of semaglutide led to a more substantial reduction in HbA1C levels when compared to thrice-daily insulin aspart. Additionally, individuals who received semaglutide treatment also experienced greater weight loss compared to those who were prescribed insulin aspart [1].
2. Weight Loss
Extensive research has been conducted on semaglutide's potential for inducing weight loss. In a 2018 study, the effect of baseline BMI and the occurrence of nausea and vomiting on semaglutide-induced weight loss was examined. The findings indicated that a higher baseline BMI was associated with significant weight loss, with no reports of nausea and vomiting. Furthermore, semaglutide showed greater weight loss effects compared to comparators, whether they received a placebo or other GLP-1 agonists, irrespective of their initial BMI [2].
In a subsequent study conducted over 52 weeks, semaglutide was found to be well-tolerated, with nausea being the most commonly observed side effect. When combined with lifestyle and dietary adjustments, semaglutide produced greater weight loss than a placebo [3]. Similarly, another study reported that overweight or obese adults who completed a 20-week lead-in period and continued semaglutide treatment experienced ongoing weight loss compared to those on placebo [4].
A literature review article published in 2023 summarized the outcomes of three clinical trials (SUSTAIN, PIONEER, and STEP) and investigated the weight loss effects of semaglutide. The review concluded that both oral and injectable forms of semaglutide exhibited superior efficacy in promoting weight loss compared to placebos and other medications. This success ultimately led to FDA approval for semaglutide's use in weight loss [5].