Semaglutide is widely used to help people with type 2 diabetes control their blood sugar.
A large study suggests that higher oral doses of the medicine may improve blood sugar control further and lead to greater weight loss.
The research was led by Dr. John Buse and published in The Lancet. The study compared three daily doses of oral semaglutide to see whether increasing the amount could provide additional benefits for people whose diabetes was not well controlled.
Type 2 diabetes develops when the body cannot use insulin properly or does not make enough of it. Insulin is a hormone that helps move sugar from the blood into cells, where it can be used for energy.
When this process does not work well, sugar builds up in the blood. Over time, high blood sugar can damage blood vessels and organs and increase the risk of heart disease, kidney disease, nerve damage, and vision problems.
Semaglutide belongs to a group of medicines that copy the effects of a natural hormone involved in blood sugar control and appetite. It can help the body release insulin when needed, slow digestion, and make people feel full for longer.
The study included 1,606 adults with type 2 diabetes. Participants were about 58 years old on average, and their A1C levels at the beginning of the study ranged from 8.0% to 10.5%.
A1C is a blood test that shows a person’s average blood sugar level over the previous two to three months. For many people with diabetes, doctors aim for an A1C below 7%, although the best target can differ from person to person.
Participants took oral semaglutide at doses of 14 milligrams, 25 milligrams, or 50 milligrams each day. Researchers followed them for about one year and compared changes in blood sugar and body weight.
All three doses improved blood sugar control, but the higher doses produced greater improvements. People taking 25 mg or 50 mg were also more likely to reach an A1C level below 7%.
The differences were especially noticeable for weight loss. People taking 14 mg lost about 10 pounds on average, while those taking 25 mg lost about 14.8 pounds.
Participants taking the highest 50 mg dose lost about 17.5 pounds on average over the study period. These results suggest that increasing the dose may provide additional weight-loss benefits for some people with type 2 diabetes.
However, higher doses also brought more side effects. The most common problems involved the digestive system, including nausea, vomiting, diarrhea, and constipation.
These effects were more frequent among people taking the 50 mg dose. Although they were generally manageable in the study, side effects remain an important consideration when doctors and patients choose a treatment.
The findings do not mean that a higher dose is automatically better for everyone. Diabetes treatment needs to consider a person’s blood sugar, weight, other health conditions, treatment goals, and ability to tolerate the medicine.
Lifestyle habits remain important alongside medication. Regular physical activity, nutritious food, enough sleep, weight management, and regular medical care can all help people manage type 2 diabetes and reduce the risk of long-term complications.
The study shows that higher doses of oral semaglutide could give doctors another way to tailor treatment. For some patients, the extra improvement in blood sugar and weight may be worthwhile, while others may do well on a lower dose with fewer side effects.
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