The role of oral semaglutide in managing type 2 diabetes in Indian clinical settings: Addressing the unmet needs.

Despite their established benefits, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) remain underutilized for type 2 diabetes mellitus (T2DM) management, which indicates that subcutaneous injection is an unfavorable mode of delivery from the patient's perspective. This review summarizes existing challenges related to medication adherence and the use of antihyperglycemia injectables, revisits the established safety and efficacy of oral semaglutide, and explores its features and considerations for use among the Indian T2DM population. We performed a literature search using MEDLINE and the National Institutes of Health Clinical Trials Registry from July 1, 2016, to July 1, 2021, to identify publications on oral semaglutide approval, T2DM treatment guidelines, and clinical evidence for oral drug formulation. Oral semaglutide is the first oral GLP-1 RA approved for T2DM patients based on phase 3, randomized PIONEER trials. The multitargeted action of this drug offers glycemic control, weight control, and cardiovascular, renal, and additional benefits, including patient convenience and enhanced medication adherence. In addition to achieving glycemic control, the cost of semaglutide is reported to be lower than other GLP-1 RA in the West, thus potentially mitigating the economic burden that appears to be high among the Indian population. Currently, there is no data available on oral semaglutide in Indian clinical settings. However, significant improvements in glycemic control, cardiac and renal benefits, as well as weight loss across clinical trials should encourage clinicians to prioritize oral semaglutide over other antidiabetic agents.

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Copyright © 2022 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest VM acted as consultant and speaker, received research or educational grants from Novo Nordisk, Johnson & Johnson, USV Private Limited, Abbott, Biocon, Astra Zeneca, Boehringer Ingelheim, Dr. Reddy's Laboratories, LifeScan, Lilly, MSD, Novartis, Roche Diabetes Care India Pvt. Ltd, Sanofi-Aventis, and other Indian pharmaceutical companies. AGU, AKS, GB, and JK received honoraria from Novo Nordisk. SJ, AD, BS, and SG received speaker honoraria from Novo Nordisk for conducting medical education lectures. No potential conflict of interest was reported by SC and RR. Novo Nordisk neither influenced the content of this publication nor was it involved in the study design, data collection, analysis, interpretation, or review.