Oral semaglutide

Weight management is a critical component of overall health, particularly for individuals with type 2 diabetes and those struggling with obesity. In recent years, the landscape of weight loss treatments has expanded with the introduction of medications that not only aid in glycemic control but also significantly contribute to weight reduction. One such groundbreaking medication is oral semaglutide which is the active ingredient found in the Novo Nordisk medication Rybelsus©. This article delves into the benefits, mechanisms, clinical evidence, and considerations associated with oral semaglutide for weight loss.

Understanding Oral Semaglutide

Oral semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a hormone that is naturally produced in the intestines and plays a crucial role in regulating blood sugar levels, appetite, and gastric emptying. Traditionally, GLP-1 receptor agonists have been available only in injectable forms, but the advent of oral semaglutide offers a more convenient option for patients. Oral semaglutide is specifically a good alternative option for people who are reluctant to initiate injectable therapy as anxiety around are commonly cited reasons for poor management in people with diabetes.

How Oral Semaglutide Works

oral semaglutide bottleOral semaglutide mimics the effects of GLP-1 by binding to GLP-1 receptors in the body, leading to several physiological responses that aid in weight loss and glycemic control:

  1. Appetite Suppression:
    • Central Nervous System: By acting on receptors in the brain, semaglutide reduces appetite and increases feelings of fullness, helping to decrease overall caloric intake.
  2. Gastric Emptying:
    • Slower Digestion: Semaglutide slows the rate at which food leaves the stomach, prolonging satiety and reducing the desire to eat soon after meals.
  3. Blood Sugar Regulation:
    • Insulin Secretion: It enhances insulin secretion in response to meals.
    • Glucagon Suppression: It reduces the secretion of glucagon, a hormone that raises blood sugar levels.

Clinical Evidence Supporting Weight Loss

Several clinical trials have demonstrated the efficacy of oral semaglutide in promoting weight loss. One of the main oral formulation studies was the PIONEER Study.

PIONEER Clinical Study Program

The PIONEER studies evaluated the effects of oral semaglutide on weight loss in individuals with type 2 diabetes. Participants were randomized to receive oral semaglutide, injectable liraglutide (another GLP-1 receptor agonist), or placebo. Results showed that oral semaglutide led to significant weight loss compared to placebo and was comparable to liraglutide.

  • Weight Loss: Participants taking oral semaglutide experienced statistically significant reductions of weight in real-world practice. Oral GLP-1 RA may offer a practical and effective option for the management of Type 2 Diabetes.
  • Glycemic Control: Improved HbA1c levels were also observed, underscoring its dual

Mechanisms Contributing to Weight Loss

Enhanced Satiety

Oral semaglutide’s ability to enhance satiety is a key mechanism driving weight loss. By acting on the hypothalamus, a brain region involved in appetite regulation, it increases the release of neurotransmitters that promote a sense of fullness.

Caloric Intake Reduction

The reduction in appetite and slower gastric emptying lead to decreased caloric intake. This dual action makes it easier for individuals to adhere to a reduced-calorie diet without experiencing intense hunger.

Benefits Beyond Weight Loss

While weight loss is a significant benefit, oral semaglutide offers additional health advantages:

  1. Improved Glycemic Control:
    • HbA1c Reduction: Oral semaglutide effectively lowers HbA1c levels, helping manage blood glucose in individuals with type 2 diabetes.
    • Postprandial Glucose: It reduces post-meal blood sugar spikes, contributing to overall glycemic stability.
  2. Cardiovascular Benefits:
    • Risk Reduction: Studies have shown that semaglutide can reduce the risk of major cardiovascular events, such as heart attacks and strokes, in individuals with type 2 diabetes and established cardiovascular disease.
  3. Lipid Profile Improvement:
    • Cholesterol Levels: Semaglutide has been associated with improvements in lipid profiles, including reductions in LDL cholesterol and increases in HDL cholesterol.

Safety and Side Effects

Oral semaglutide is generally well-tolerated, but like any medication, it can have side effects. The most common side effects are gastrointestinal, including:

  1. Nausea:
    • Management: Gradually increasing the dose can help mitigate nausea. For more severe nausea it may be recommended to take an anti-nausea medication or skip a day or two and let the body acclimate more slowly as everyone responds differently.
  2. Diarrhea:
    • Transient: This side effect is often temporary and resolves with continued use.
  3. Constipation:
    • Hydration and Fiber: Increasing water intake and dietary fiber can help manage constipation.

Considerations for Use

Eligibility

Oral semaglutide is suitable for adults with a body mass index (BMI) of 30 or higher, or those with a BMI of 27 or higher who have weight-related health conditions such as hypertension, type 2 diabetes, or dyslipidemia. Ultimate determination of who would benefit from medication assisted weight loss is at the prescribing physician’s discretion.

Dosing and Administration

  • Initial Dose: Treatment typically starts with a low dose of 3mg for 30 days to minimize gastrointestinal side effects.
  • Maintenance Dose: The dose is gradually increased to the therapeutic level over several weeks, often reaching 14mg a day.

Dosage varies on formulation type, as oral routes can be compounded in a standard capsule, sublingual or oral liquid. It is important to not eat or drink 30-minutes prior to taking oral semaglutide, with no more than 4 oz of plain water. If you wait at least 30 min after to eat or drink, the medication may absorb better.

Integration with Lifestyle Changes

For optimal results, oral semaglutide should be used in conjunction with lifestyle modifications, including:

  1. Diet:
    • Balanced Nutrition: A diet rich in vegetables, fruits, lean proteins, and whole grains is recommended.
    • Caloric Deficit: Reducing caloric intake is crucial for weight loss.
  2. Exercise:
    • Regular Activity: Incorporating regular physical activity, such as walking, swimming, or resistance training, enhances weight loss and overall health.

Patient Experiences and Success Stories

overweight photoMany patients have reported positive experiences with oral semaglutide. Testimonials often highlight significant weight loss, improved energy levels, and better blood glucose control. Healthcare providers also note the medication’s efficacy in promoting long-term weight management and overall health improvements.

Start Your Weight Loss Journey

Oral semaglutide represents a significant advancement in the treatment of obesity and type 2 diabetes. Its ability to promote substantial weight loss, improve glycemic control, and provide cardiovascular benefits makes it a valuable tool for individuals seeking to manage their weight and improve their health. As with any medication, it is important for patients to work closely with their healthcare providers to ensure that oral semaglutide is used safely and effectively as part of a comprehensive weight management plan. Compassionate Healthcare’s physicians specialize in alternative medicine therapies and partner with our patient to provide safe and effective lifestyle improvements. The process is simple and pricing for Semaglutide starts at only $270 a month! Call one our offices or make a convenient telehealth appointment today!

Sources

Aroda VR, Ahmann A, Cariou B, Chow F, Davies MJ, Jódar E, et al. Comparative efficacy, safety, and cardiovascular outcomes with once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes: Insights from the SUSTAIN 1–7 trials. Diabetes Metab. 2019;45(5):409–418. doi: 10.1016/j.diabet.2018.12.001. Insights into the early use of oral semaglutide in routine clinical practice: The IGNITE study – PMC (nih.gov)

Nauck MA, Quast DR. Cardiovascular safety and benefits of semaglutide in patients with type 2 diabetes: findings from SUSTAIN 6 and PIONEER 6. Front Endocrinol (Lausanne) 2021;12:645566. doi: 10.3389/fendo.2021.645566. Cardiovascular Safety and Benefits of Semaglutide in Patients With Type 2 Diabetes: Findings From SUSTAIN 6 and PIONEER 6 – PMC (nih.gov)

Khunti K, Gomes MB, Pocock S, Shestakova MV, Pintat S, Fenici P, et al. Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: a systematic review. Diabetes Obes Metab. 2018;20(2):427–437. doi: 10.1111/dom.13088. Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review – PMC (nih.gov)

Williams DM, Ruslan AM, Khan R, Vijayasingam D, Iqbal F, Shaikh A, et al. Real-world clinical experience of semaglutide in secondary care diabetes: a retrospective observational study. Diabetes Ther. 2021;12(3):801–811. doi: 10.1007/s13300-021-01015-z. Real-World Clinical Experience of Semaglutide in Secondary Care Diabetes: A Retrospective Observational Study – PMC (nih.gov)

Davies MJ, Gagliardino JJ, Gray LJ, Khunti K, Mohan V, Hughes R. Real-world factors affecting adherence to insulin therapy in patients with type 1 or type 2 diabetes mellitus: a systematic review. Diabet Med. 2013;30(5):512–524. doi: 10.1111/dme.12128. Real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus: a systematic review – PubMed (nih.gov)