Diabetes, Metabolic Syndrome and Obesity (Jun 2023)
A Peptide in a Pill – Oral Semaglutide in the Management of Type 2 Diabetes
Abstract
Raja Selvarajan,1,* Rashmi Subramanian2,* 1Department of Diabetes and Research Kaveri Healthcare, Bangalore, Karnataka, India; 2Department of Research and Development, Kaveri Healthcare, Bangalore, Karnataka, India*These authors contributed equally to this workCorrespondence: Raja Selvarajan, Tel +91 9902561571, Email [email protected]: T2DM (type 2 diabetes mellitus) is a chronic and progressive illness with high morbidity and death rates. Oral semaglutide (Rybelsus®) is a combination of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), and sodium N- (8- [2-hydroxybenzoyl] amino) caprylate (SNAC), an absorption enhancer that facilitates semaglutide absorption across the gastric epithelium in a concentration-dependent manner. This family of drugs apart from glucose lowering effects causes significant weight loss with lower risk of hypoglycemia, and some of them have been linked to a significant reduced major adverse cardiovascular events. GLP-1 RAs may assist persons with T2DM and chronic kidney disease (CKD), a major microvascular consequence of T2DM, in ways other than lowering blood sugar. Several large clinical studies, the bulk of which are cardiovascular outcome trials, show that GLP-1 RA treatment is safe and tolerated for persons with T2DM and impaired renal function and that it may potentially have renoprotective characteristics. This article focuses on the advances of oral GLP1-RA and describes the key milestones and predicted advantages.Keywords: type 2 diabetes mellitus, incretin system, GLP-1 receptor agonist, oral semaglutide, pioneer trials
