Effects of Adding Semaglutide to Basal-Bolus or Mixed Insulin Therapy: A Retrospective Chart Review

Abstract

Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), has demonstrated beneficial effects when incorporated into basal insulin therapy. Despite mounting evidence from diverse geographical regions supporting its efficacy in more intricate insulin regimens for patients with type 2 diabetes (T2DM), there remains a scarcity of real-world data from our region. This study aims to assess the impact of adding Semaglutide to the basal-bolus or mixed insulin therapy over a 12-month period on glycated hemoglobin (HbA1c), weight, and total daily dose (TDD) of insulin. Methods: A retrospective chart review was conducted at a military medical center in Riyadh from January 2021 to September 2022. The study included all adult patients with T2DM who experienced clinical benefit from the addition of Semaglutide to basal-bolus or mixed insulin therapy during this timeframe. Measurements of HbA1c, weight, and TDD were obtained at baseline, 3, 6, and 9 months. Descriptive statistics and one-way ANOVA tests were utilized for statistical analysis. Results: The study cohort comprised 152 patients, of whom 105 (69.1%) were female, with a mean age of 57.7±11.4 years. There was a significant reduction in mean HbA1c levels from 9.32 at baseline to 8.62, 8.28, and 8.36 at three, six, and nine months, respectively (p-value <0.001). Moreover, mean weight in kilograms (kg) decreased from 94.8 kg at baseline to 93.54, 92.46, and 91.94 kg at three, six, and nine months, respectively (p-value > 0.005). Conclusion: This study demonstrates that the addition of Semaglutide to the current treatment regimen of patients with T2DM leads to improvements in HbA1c levels, accompanied by observed reductions in weight over nine months in individuals utilizing basal-bolus or mixed insulin therapy. Further studies with extended follow-up periods are warranted to validate these findings.