Add on semaglutide leads to better blood sugar control compared to canagliflozin in diabetes: Lancet
In cases where blood sugar and glycated hemoglobin is not controlled properly with Metformin alone, it is endeavor of treating doctors to add diabetes drugs so that various parameters of investigations are within normal limits.
Adding semaglutide a GLP receptor agonist to metformin leads to better blood sugar control compared to adding SGLT2 inhibitor canagliflozin in uncontrolled diabetes finds a study published in the Lancet.
The existing guidelines for management of type 2 diabetes recommend a patient-centred approach to guide the choice of pharmacological agents. Although glucagon-like peptide-1 (GLP-1) receptor agonists and sodium–glucose cotransporter-2 (SGLT2) inhibitors are increasingly used as second-line agents, direct comparisons between these treatments are insufficient.
The researchers have compared the efficacy and safety of semaglutide (a GLP-1 receptor agonist) with canagliflozin (an SGLT2 inhibitor) in patients with type 2 diabetes in the SUSTAIN 8 trial.
The new study has found that in patients with uncontrolled type 2 diabetes who are taking metformin, adding the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide improves hemoglobin A1c levels better than the sodium–glucose cotransporter-2 (SGLT2) inhibitor canagliflozin, according to a trial findings published in the Lancet Diabetes & Endocrinology.
In the study nearly 800 adults were randomized to add-on treatment with either subcutaneous semaglutide (1 g once weekly) or oral canagliflozin (300 mg once daily). By 1 year, the mean HbA1c level had dropped significantly more with semaglutide than canagliflozin (a decrease of 1.5 vs. 1.0 percentage points). Additionally, a greater proportion of semaglutide recipients than canagliflozin recipients achieved HbA1c levels under 7% (66% vs. 45%).
Patients on semaglutide also lost more weight (mean loss, 5.3 vs. 4.2 kg).
The researchers concluded that Once-weekly semaglutide 1·0 mg was superior to daily canagliflozin 300 mg in reducing HbA 1c and bodyweight in patients with type 2 diabetes uncontrolled on metformin therapy. These outcomes might guide treatment intensification choices.
They further added, "These outcomes might guide treatment intensification choices." Commentators, however, caution that adverse events, cost, and comorbid conditions also must be considered, and they advocate for a "personalized approach" to treatment.
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Lancet Diabetes & Endocrinology article (Free abstract
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