A nationwide Finnish study shows that oral semaglutide was linked to meaningful metabolic improvements in everyday diabetes care, including among older adults who are often underrepresented in clinical trials, according to a June 11 report.
Researchers conducted a retrospective observational study using Finland's national health registers, including more than 7,000 adults with type 2 diabetes who started oral semaglutide between April 1, 2021, and December 31, 2023. The primary endpoints were changes from baseline in glycated hemoglobin (HbA1c) and total body weight at six and twelve months after starting the medication. Secondary endpoints included cholesterol levels and liver enzyme markers.
The study found significant improvements in blood sugar control, reduced body weight, improved several lipid markers, and reduced alanine aminotransferase (ALT), a liver enzyme marker. Once-daily oral semaglutide was associated with lower HbA1c levels and one-year weight loss across age groups, including those aged 75 years or older. Among all participants modeled over time, mean HbA1c decreased from a baseline of 7.9% to 6.8% at six months and remained stable at one year. Mean body weight dropped from 106 kilograms at baseline to 98 kilograms by the end of one year.
Cardiovascular risk factors also improved: LDL cholesterol fell from a baseline of 2.5 mmol/L to 2.0 mmol/L at six months; ALT dropped from an initial value of 50 U/L down to 37 U/L after one year. Women achieved greater relative weight loss than men over the same period.
The authors said that while nearly half of participants discontinued treatment within a year, and acknowledged reliance on sometimes incomplete clinical records as well as lack of a control group or adjustment for confounding factors such as lifestyle changes or other medications, their findings support real-world effectiveness rather than causal proof.
The research received support from Novo Nordisk Pharma; several authors reported financial relationships with Novo Nordisk or employment/shareholdings with the company.
