GLP1-agonist(BNC Korea/SML Biopharm)

Information on therapeutic inertia (TI) in weight loss in people with type 2 diabetes (T2D) is limited.

To describe the prevalence of TI in the management of overweight/obesity in people with T2D undergoing primary care program (PCP) follow‐up and weight changes according to the prescribed treatment.

A retrospective longitudinal study was conducted in patients with T2D with body mass index (BMI) ≥ 25 kg/m 2 followed by PCP. The following data were obtained from medical records at the first assessment, 6 and 12 months: anthropometric data, HbA1c, medications added according to their effect on weight, and specialist referrals (nutrition and metabolic and bariatric surgery).

A total of 128 patients were included (age 65.5 ± 11.7 years, HbA1c 7.8 ± 1.7%, BMI 33.1 ± 5.7 kg/m 2 ). The mean HbA1c at the end of follow‐up was 7.4% ± 1.4%. Twenty‐five percent achieved ≥ 5% weight loss after 12 months. The proportion of patients without weight‐loss interventions increased from 59% in the first assessment to 86% and 89% after 6 and 12 months of follow‐up. Patients who lost ≥ 5% of their weight were more likely to be referred to dietary counseling at program entry (37.5% vs. 23.4%) and at 6 months (18.8% vs. 6.4%) compared to patients who gained weight. In addition, the prescription of SGLT2 inhibitors/GLP1‐receptor agonist was higher in this group at 6 months (49.3% vs. 10.7%).

Although there was a reduction in HbA1c, the TI for prescribing weight‐loss interventions was high. This suggests the importance of including weight loss as a therapeutic goal alongside lowering HbA1c in primary care.

Women with polycystic ovary syndrome (PCOS) have a higher prevalence of obesity, which negatively impacts health. Guidelines suggest that GLP1 Receptor Agonists could be considered but highlight a lack of evidence for treatment in PCOS. Reducing body weight by as little as 5% has significant benefits in women with PCOS.

The aim of this retrospective study was to analyse the metabolic impact of semaglutide use in routine clinical practice in obese women with PCOS.

Data were collected on 58 women with PCOS and obesity attending reproductive endocrinology clinics and prescribed semaglutide therapy for > 6 months.

Mean age was 34.7 ± 6.8 years. Median duration of GLP1 agonist therapy was 12(7-17) months. Mean weight loss was 12.6 ± 9.6 kg (11.4% total body weight, p < 0.0001). 81% of women lost > 5% of their total body weight. Mean BMI reduced from 40.7 ± 6.3 to 36.2 ± 6.7 kg/m² (p < 0.0001). Mean systolic blood pressure reduced by 6.3mmHg (p = 0.012). Median HbA1C reduced from 35.3 (32.8-38.3) to 33 (31-35) mmol/mol (p = 0.0014). Mean total cholesterol reduced from 4.8 ± 0.9 mmol/L to 4.45 ± 0.91 mmol/L, p = 0.03. 50% of those with oligomenorrhoea reported subjective improvement in their menstrual cycles. 33% of those with acne and 29% of those with hirsutism reported improvements in their symptoms.

In this real-world analysis of clinical practice, semaglutide use in obese women with PCOS was associated with significant weight loss, reduced systolic blood pressure, cholesterol and HbA1C.