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Article: Semaglutide

Semaglutide - HealthBrew Clinic

Semaglutide


Semaglutide, sold under brand names like Ozempic and Wegovy, has gained significant attention for its role in managing type 2 diabetes and chronic weight issues. This comprehensive guide delves into its history, how it works, and key safety information.

History

Originally developed by Novo Nordisk, Semaglutide received FDA approval in 2017 for treating type 2 diabetes as Ozempic. An oral formulation, Rybelsus, was approved in 2019. By 2020, it also received approval for chronic weight management under the name Wegovy.

Mechanism of Action

Semaglutide is a GLP-1 (glucagon-like peptide-1) receptor agonist. When it binds to GLP-1 receptors, especially in the pancreas, it activates processes like:

  • Insulin Release: Boosts insulin secretion, helping to lower blood sugar.
  • Inhibition of Glucagon: Prevents glucagon release, reducing blood sugar increase.
  • Gastric Emptying: Slows down digestion, managing post-meal blood sugar spikes.
  • Appetite Suppression: Influences brain receptors, aiding in weight management.

FDA Indications

  • Type 2 Diabetes: Used alongside diet and exercise for glycemic control.
  • Chronic Weight Management: For adults with certain weight-related conditions.

Off-Label Indications

  • PCOS: Studies indicate potential use, but not FDA-approved for this purpose.

Clinical Evidence

  • Weight Loss: 32% of STEP 1 trial participants lost over 20% body weight.
  • Type 2 Diabetes: Key trials showcased an HbA1c level drop of 1.5 points.
  • Cholesterol: 5% average reduction in LDL cholesterol levels.

Warnings and Precautions

  • Thyroid C-cell Tumors: Risk exists, particularly with a history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
  • Pancreatitis: Cases reported; discontinue use if suspected.
  • Diabetic Retinopathy: Monitor for vision changes; may worsen existing condition.

Side Effects

  • Common: Nausea, vomiting, diarrhea.
  • Serious: Thyroid C-cell tumors, pancreatitis.

Adverse Reactions

  • Gastrointestinal: Gastrointestinal issues are common but often subside.
  • Injection-site Reactions: Redness, swelling may occur; usually mild.

Drug Interactions

  • Antidiabetic Drugs: Risk of hypoglycemia; monitor closely.
  • Digoxin: Requires monitoring if used with heart medications.

Contraindications

  • Medullary thyroid carcinoma history
  • Multiple Endocrine Neoplasia syndrome type 2
  • Known hypersensitivity to the product

Use in Specific Populations

  • Pregnancy: Not recommended; lacks adequate studies.
  • Pediatric: Safety and efficacy not established for children.

Patient Considerations

Store medication in a refrigerator. Typically administered via subcutaneous injection.

Conclusion

Semaglutide offers a multi-faceted approach to managing diabetes and weight, but it's essential to consult a healthcare provider for individualized treatment.


References

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