Semaglutide in people with obesity and type 2 diabetes on hemodialysis: a prospective analysis of glycemic and weight outcomes

Abstract Aim/introduction The effects of weekly semaglutide on glucose profiles and body weight in people with obesity and type 2 diabetes (T2D) undergoing maintenance hemodialysis (HD) remain poorly understood. Material and methods This single-arm, observational study evaluated the effects and safety of weekly semaglutide in 11 people with obesity and T2D on HD (seven men, 57 ± 10 years). Continuous glucose monitoring (CGM) was used to assess changes in glycemic profiles, and changes in dry weight were also analyzed. Results After 6 months of treatment, hemoglobin A1c (HbA1c) and glycated albumin significantly decreased from 7.8 ± 1.2% and 23.6 ± 5.2% to 6.9 ± 1.1% and 19.6 ± 4.3%, respectively ( P = 0.0318, P = 0.0062). CGM data showed that mean sensor glucose levels decreased from 172.0 ± 36.2 mg/dL to 138.1 ± 25.4 mg/dL ( P = 0.0177), and glucose variability (standard deviation) decreased from 56.8 ± 24.4 mg/dL to 42.1 ± 12.8 mg/dL ( P = 0.0264). Time in range (70–180 mg/dL) significantly increased from 57.0% (34.0–86.0%) to 78.0% (51.4–97.0%) ( P = 0.0420). Additionally, semaglutide significantly reduced dry weight from 86.2 ± 12.7 kg to 83.2 ± 13.1 kg ( P = 0.0285). No serious adverse events were observed. Conclusions These findings suggest that weekly semaglutide is a safe and effective option for improving glycemic control and weight management in people with obesity and T2D on HD.