Perreault, Leigh, Davies, Melanie, Frias, Juan P, Laursen, Peter Norkjaer, Lingvay, Ildiko, Machineni, Sriram, Varbo, Anette, Wilding, John PH ORCID: 0000-0003-2839-8404, Wallenstein, Signe Olrik Rytter and le Roux, Carel W
(2022)
Changes in Glucose Metabolism and Glycemic Status With Once-Weekly Subcutaneous Semaglutide 2.4 mg Among Participants With Prediabetes in the STEP Program.
DIABETES CARE, 45 (10).
pp. 2396-2405.
Text
DC21-1785.R1_Revised manuscript_accepted.docx - Author Accepted Manuscript Download (144kB) |
Abstract
<h4>Objective</h4>This analysis of 3,375 adults with overweight/obesity across the Semaglutide Treatment Effect in People with obesity (STEP) 1, 3, and 4 trials evaluated whether more participants with prediabetes had normoglycemia after 68 weeks' treatment with once-weekly semaglutide 2.4 mg plus lifestyle intervention versus placebo and assessed changes in glucose metabolism in participants with prediabetes.<h4>Research design and methods</h4>STEP 1, 3, and 4 were phase 3, 68-week, randomized, placebo-controlled, multinational trials; STEP 4 had a 20-week semaglutide run-in and 48-week randomized period. Analyses included changes (week 0-68; before the washout period) in glycemic status (prespecified: STEP 1 and 3; post hoc: STEP 4), and in HbA1c, fasting plasma glucose (FPG), and HOMA insulin resistance (HOMA-IR) among participants with prediabetes (post hoc).<h4>Results</h4>Significantly more participants with baseline (week 0) prediabetes (n = 1,536) had normoglycemia at week 68 with semaglutide versus placebo (STEP 1, 84.1% vs. 47.8%; STEP 3, 89.5% vs. 55.0%; STEP 4, 89.8% vs. 70.4%; all P < 0.0001). Fewer participants with baseline normoglycemia had prediabetes at week 68 with semaglutide versus placebo (STEP 1, 2.9% vs. 10.9%; STEP 3, 3.2% vs. 5.8%; STEP 4, 1.1% vs. 5.0%). Semaglutide resulted in greater improvements in HbA1c, FPG, and HOMA-IR than placebo among participants with baseline prediabetes (all P < 0.01).<h4>Conclusions</h4>STEP 1, 3, and 4 collectively provide a robust assessment of the effects of semaglutide on glucose metabolism and prediabetes in a large cohort of adults with overweight/obesity while on treatment. Among participants with baseline prediabetes, 68 weeks' treatment with semaglutide versus placebo led to significant improvements in glucose metabolism and a higher likelihood of normoglycemia.
Item Type: | Article |
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Uncontrolled Keywords: | Humans, Diabetes Mellitus, Type 2, Prediabetic State, Insulin Resistance, Obesity, Blood Glucose, Hypoglycemic Agents, Double-Blind Method, Adult, Overweight, Glucagon-Like Peptides, Glycated Hemoglobin |
Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
Depositing User: | Symplectic Admin |
Date Deposited: | 08 Aug 2022 07:59 |
Last Modified: | 16 Feb 2023 19:48 |
DOI: | 10.2337/dc21-1785 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3160451 |