Type 2 diabetes affects hundreds of millions of people around the world. It develops when the body does not respond properly to insulin, the hormone that helps move sugar from the bloodstream into cells where it can be used for energy.
When blood sugar stays too high for years, it can damage blood vessels and organs. This can increase the risk of heart disease, kidney disease, vision loss, nerve damage, and other serious health problems.
Doctors often use a blood test called HbA1c to see how well diabetes is being controlled. Unlike a single blood sugar reading, HbA1c gives an estimate of a person’s average blood sugar over the previous two to three months.
An international clinical trial has examined whether higher daily doses of the diabetes medicine semaglutide could improve blood sugar control and weight loss. The research was led by Dr. Vanita R. Aroda of Brigham and Women’s Hospital in Boston and was published in the medical journal The Lancet.
Semaglutide works by copying the effects of a natural hormone that helps the body control blood sugar and appetite. It can encourage the pancreas to release insulin when needed, slow the movement of food through the stomach, and help people feel full for longer.
The study included more than 1,600 adults from 177 research sites across 14 countries. Participants already used between one and three medicines for diabetes, but their blood sugar remained above the desired range.
At the beginning of the trial, participants had HbA1c levels between 8.0% and 10.5%. They were randomly assigned to take a daily semaglutide tablet containing 14 mg, 25 mg, or 50 mg.
Treatment continued for 68 weeks, or a little more than a year. Researchers then compared changes in blood sugar and body weight among the three groups.
All three doses helped lower HbA1c, but the higher doses produced larger improvements. People taking 25 mg or 50 mg generally experienced greater reductions in average blood sugar than those taking the 14 mg dose.
The higher doses also produced greater weight loss. This can be especially useful for many people with type 2 diabetes because excess body weight can make it harder for the body to respond to insulin and can add to the risk of heart and blood vessel disease.
However, stronger treatment also came with more side effects. Digestive problems such as nausea, vomiting, and diarrhea were among the most common unwanted effects, and they occurred more often in people receiving the higher doses.
Most of these problems were described as mild to moderate and often became less troublesome over time. Even so, side effects are an important consideration because a medicine is only useful if patients can safely continue taking it.
The findings suggest that higher-dose oral semaglutide could provide another treatment option for some people whose type 2 diabetes remains poorly controlled with their existing medicines. Having a treatment that improves both blood sugar and body weight could be particularly valuable for patients who need additional help in both areas.
Higher doses will not necessarily be the best choice for everyone, and people should not change their semaglutide dose on their own. Doctors need to consider blood sugar levels, other health conditions, current medicines, treatment goals, and possible side effects when deciding which approach is appropriate.
If you care about diabetes, please read studies about Vitamin D and type 2 diabetes, and to people with diabetes, some fruits are better than others.
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