Semaglutide Improved Beta-Cell Function and Glycemic Control in Type 2 Diabetes

Semaglutide significantly increased insulin response and was well-tolerated in patients with type 2 diabetes.

A 12-week regimen of once-weekly semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, benefited beta-cell function and glycemic control in patients with type 2 diabetes, according to data published in Diabetologia.

The researchers of the single-center, double-blind, placebo-controlled, parallel-group trial ( identifier: NCT02212067) enrolled 75 adult patients with type 2 diabetes. Patients were randomly assigned 1:1 to once-weekly subcutaneous semaglutide 1 mg (0.25, 0.5, 1.0 mg escalated; n=37) or placebo (n=38) for 12 weeks.


Eligibility criteria included a hemoglobin A1c level between 6.5% and 9%, a body mass index between 20 kg/m2 and 35 kg/m2, and treatment with diet and exercise and/or metformin monotherapy with a dose that was unchanged in the 30 days prior to screening.

Co-primary end points were defined as changes from baseline to end of treatment in the first (area under the curve [AUC], 0-10 minutes) and second (AUC, 10-120 minutes) insulin secretion phases, as calculated by the intravenous glucose tolerance test (IVGTT).

Additionally, researchers performed the following tests: an arginine stimulation test (AST), a 24-hour meal stimulation test, and a graded glucose infusion test (GGIT) for determining the insulin secretion rate.

Twelve-week results indicated that after IVGTT, semaglutide significantly increased insulin responses compared with placebo during the first phase (estimated treatment ratio [ETR], 3.02; 95% CI, 2.53-3.60) and second phase (ETR, 2.10; 95% CI, 1.86-2.37; P for both <.0001).

Furthermore, the 24-hour meal test demonstrated decreased fasting, postprandial, and overall (AUC, 0-24 hours) glucose and glucagon responses with semaglutide (P <.0001), while the AST suggested that maximal insulin capacity rose with semaglutide.

In GGIT analysis, semaglutide significantly increased the insulin secretion rate to levels comparable with rates in healthy patients (n=12).

The researchers also documented that semaglutide was well tolerated.

“[T]he results of the current study are consistent with previous findings during treatment with the GLP-1 analogue liraglutide,” the researchers wrote, “and suggest that treatment with semaglutide may offer a protective effect on beta-cell function. In addition, the results show that semaglutide is a promising once-weekly GLP-1 analogue for the treatment of type 2 diabetes, associated with improved beta-cell responsiveness comparable with that observed in healthy individuals.”

The researchers added that the improved glycemic responses observed in the study appeared to be a combined effect on the pancreas of increased insulin secretion and decreased glucagon response

Disclosures: The study was funded by Novo Nordisk A/S. Four researchers report being full-time employees of Novo Nordisk A/S, and one reports financial disclosures with Novo Nordisk and other pharmaceutical manufacturers.

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Kapitza C, Dahl K, Jacobsen JB, Axelsen MB, Flint A. Effects of semaglutide on beta cell function and glycaemic control in participants with type 2 diabetes: a randomised, double-blind, placebo-controlled trial [published online May 19]. Diabetologia. 2017. doi:10.1007/s00125-017-4289-0