Oral Semaglutide in Routine Clinical Practice: 24‐Month Real‐World Effectiveness, Persistence and Safety in Adults With Type 2 Diabetes
- 1Department of Medicine and Aging Sciences G. D'Annunzio University of Chieti‐Pescara Chieti Italy
- 2Center for Advanced Studies and Technology (CAST) G. D'Annunzio University of Chieti‐Pescara Chieti Italy
- 3Endocrinology and Metabolic Disease Clinic of Pescara Pescara Italy
Abstract
Aims: Real‐world long‐term data on oral semaglutide are limited. We evaluated its 24‐month effectiveness, persistence, and safety in adults with type 2 diabetes (T2D).
Materials and Methods: This retrospective real‐world study included 232 adults with T2D initiating oral semaglutide at an Italian diabetes clinic. Changes in HbA1c, body weight, eGFR, urinary albumin‐to‐creatinine ratio (UACR) and lipid profile were assessed using linear mixed models. The composite endpoint of HbA1c ≤ 7% and ≥ 5% weight loss was assessed over follow‐up. Treatment persistence was evaluated by Kaplan–Meier analysis, and predictors of discontinuation by multivariable Cox regression with time‐dependent covariates. HbA1c and body weight before and after switching to another GLP1 receptor agonist were also evaluated.
Results: Over 24 months, oral semaglutide significantly reduced HbA1c (−0.8%; p < 0.0001) and body weight (−5.7 kg; p < 0.0001). The composite endpoint was progressively achieved by 44.0% of individuals at 24 months. Non‐breakfast administration was independently associated with lower HbA1c after adjustment for BMI, age and sex (β = −0.32; p = 0.041). eGFR and UACR remained stable while total and LDL cholesterol decreased significantly (both p < 0.0001). Treatment persistence at 24 months was 68.5% (mean 19.4 months). Among discontinuers, switching to another GLP1 receptor agonist was the most common strategy (36.2%) and resulted in a further HbA1c reduction (Δ = −0.98%; p = 0.005). No safety concerns emerged.
Conclusions: In this real‐world cohort, oral semaglutide provided sustained improvements in glycaemic control, body weight, and lipid profile, with preserved renal function and high treatment persistence over 24 months.
Related
- Effectiveness and safety of imeglimin in routine clinical practice among Indian patients with type 2 diabetes mellitus: a prospective, non-interventional, real-world observational study (INDI-TIMES 2.0)
- Short-term clinical efficacy and recorded adverse events of semaglutide combined with dapagliflozin in patients with type 2 diabetes mellitus and chronic kidney disease
- Post-Initiation Care Patterns and Weight Loss With Semaglutide and Tirzepatide for Obesity in Clinical Practice
- Effectiveness of Discrete Strategies and Implementation Bundles for Improving Clinician Prescription of Clinical Practice Guideline–Recommended Medications for Atherosclerotic Occlusive Disease: A Systematic Review and Meta‐Analysis
- 2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes or type 2 diabetes
BibTeX
@article{baldassarre2026oral,
title = {{Oral Semaglutide in Routine Clinical Practice: 24‐Month Real‐World Effectiveness, Persistence and Safety in Adults With Type 2 Diabetes}},
author = {Maria Pompea Antonia Baldassarre and Giulia Di Dalmazi and Federica Carrieri and Giorgia Centorame and Luigi Piacentino and Sara Coluzzi and Gloria Formoso},
journal = {Diabetes, Obesity \& Metabolism},
year = {2026},
month = sep,
doi = {10.1111/dom.71371},
url = {https://doi.org/10.1111/dom.71371},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Oral Semaglutide in Routine Clinical Practice: 24‐Month Real‐World Effectiveness, Persistence and Safety in Adults With Type 2 Diabetes
AU - Maria Pompea Antonia Baldassarre
AU - Giulia Di Dalmazi
AU - Federica Carrieri
AU - Giorgia Centorame
AU - Luigi Piacentino
AU - Sara Coluzzi
AU - Gloria Formoso
PY - 2026
DA - 2026/09/21
JO - Diabetes, Obesity & Metabolism
DO - 10.1111/dom.71371
UR - https://doi.org/10.1111/dom.71371
AB - Aims: Real‐world long‐term data on oral semaglutide are limited. We evaluated its 24‐month effectiveness, persistence, and safety in adults with type 2 diabetes (T2D). Materials and Methods: This retrospective real‐world study included 232 adults with T2D initiating oral semaglutide at an Italian diabetes clinic. Changes in HbA1c, body weight, eGFR, urinary albumin‐to‐creatinine ratio (UACR) and lipid profile were assessed using linear mixed models. The composite endpoint of HbA1c ≤ 7% and ≥ 5% weight loss was assessed over follow‐up. Treatment persistence was evaluated by Kaplan–Meier analysis, and predictors of discontinuation by multivariable Cox regression with time‐dependent covariates. HbA1c and body weight before and after switching to another GLP1 receptor agonist were also evaluated. Results: Over 24 months, oral semaglutide significantly reduced HbA1c (−0.8%; p < 0.0001) and body weight (−5.7 kg; p < 0.0001). The composite endpoint was progressively achieved by 44.0% of individuals at 24 months. Non‐breakfast administration was independently associated with lower HbA1c after adjustment for BMI, age and sex (β = −0.32; p = 0.041). eGFR and UACR remained stable while total and LDL cholesterol decreased significantly (both p < 0.0001). Treatment persistence at 24 months was 68.5% (mean 19.4 months). Among discontinuers, switching to another GLP1 receptor agonist was the most common strategy (36.2%) and resulted in a further HbA1c reduction (Δ = −0.98%; p = 0.005). No safety concerns emerged. Conclusions: In this real‐world cohort, oral semaglutide provided sustained improvements in glycaemic control, body weight, and lipid profile, with preserved renal function and high treatment persistence over 24 months.
SN - 1462-8902
SN - 1463-1326
ER -