Real-world Use of Oral Semaglutide in Patients with Type 2 Diabetes in India: A Retrospective Study

Abstract Background: Oral semaglutide has shown efficacy in clinical trials worldwide; however, real-world evidence in Indian settings is scarce. The current study examined the effectiveness of oral semaglutide in patients with type 2 diabetes within the context of routine clinical practice in Indian settings. Methodology: This retrospective, multicenter, observational study assessed the effectiveness of oral semaglutide in adult patients with type 2 diabetes who had inadequate glycemic control (HbA1c ≥6.5). The included patients need to have ≥1 HbA1c report within 12 weeks of the study initiation. The primary end point was change in HbA1c% from baseline to end of study (EOS; 30 weeks), with secondary end points including changes in body weight, waist circumference, and body mass index (BMI). These end points were evaluated for patients who were on oral semaglutide at EOS. Results: Of 414 screened patients, 340 were included in the study, with 176 patients on oral semaglutide at EOS. A mean reduction of 0.96 ± 1.02% ( P < 0.001) in HbA1c from baseline to EOS was observed, with greater reductions in patients with 5–10 years of diabetes. At EOS, 92.6% of patients achieved a target of ≥1% HbA1c reduction from baseline. In addition, significant reductions in body weight (6.04 ± 5.40 kg, P < 0.001), waist circumference (3.47 ± 5.42 cm, P < 0.001), and BMI (1.94 ± 1.42 kg/m 2 , P < 0.001) were observed at EOS. Conclusion: Oral semaglutide shows promise as a therapeutic option for glycemic control and weight management in diabetic patients in Indian settings. However, further randomized clinical trials in Indian patients are warranted to validate these findings and optimize further treatment strategies.