Blood sugar levels better controlled by higher dose of oral semaglutide

New Delhi: Higher doses of oral semaglutide, a widely taken blood sugar medication, have been associated with better control over blood sugar levels and more weight loss than lower doses, scientists have published in the journal The Lancet.

They found that once-daily oral semaglutide taken at 25 milligrams (mg) and 50 mg did a better job in lowering blood sugar levels and promoting weight loss than the lowest dose of 14 mg.

"Low doses of GLP-1 receptor agonists are really powerful for reducing A1C, or the average glucose in the blood whereas, the higher doses are really good for weight reduction.

"On average, patients lost eight kilograms at 50 milligrams, which is nearly twice as much weight loss that we saw with the lowest dose," said John Buse, study author and professor of Medicine, University of North Carolina Health Care, US.

Diabetes is characterised by abnormally high blood glucose levels, excessive urination and persistent thirst and becomes more severe over time, making it more difficult for the patient to manage blood sugar levels.

Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has been known to grant patients more control in lowering of blood sugar.

Blood sugar levels are measured through a percentage, called A1C. According to the American Diabetes Association, diabetic adults with A1C less than 7 per cent are considered healthy.

In this study, 1,606 diabetic participants, on average male and aged 58.2 years, were divided randomly into three groups and asked to take oral semaglutide once a day. For 52 weeks, each group took either a 14 mg dosage, a 25 mg dosage, or a 50 mg dosage. All the participants had an A1C between 8 and 10.5 per cent.

Those receiving the 25 mg and 50 mg doses of oral semaglutide were found to be more likely to reach the A1C target of less than 7 per cent, compared with those who took 14 mg.

Semaglutide is known to also cause weight loss by suppressing appetite.

At the end of the 52 weeks, the participants who took 50 mg of oral semaglutide had lost, on average, 8 kilograms (kgs). Those who took 25 mg and 14 mg lost about 7 kgs and 4.5 kgs, respectively, the researchers found.

However, the researchers noted, the participants also experienced side effects, the most common of which was nausea, owing to the effect the drug has on the fullness of the stomach.

Some of the participants also reported experiencing vomiting, diarrhea, and/or constipation, particularly those who took the higher doses of 25 mg and 50 mg.