Visual Abstract

High glycemic variability (GV) is independently associated with adverse clinical outcomes such as micro-/macrovascular complications. As glucose-dependent action of once-weekly (OW) semaglutide may translate to reduced GV, we compared within-day GV of OW semaglutide vs. active comparators in people with type 2 diabetes (T2D).

This post hoc analysis was based on individual subject data in the full analysis set (n=5,680) from the on-treatment without rescue medication period in SUSTAIN 2-4, 7, 8 and 10. GV was assessed as change from baseline to end of treatment in standard deviation (SD) of the self-measured blood glucose (SMBG) over the day, if measured ≥6 times. Multiple imputation was used for missing SD values.

The average baseline SD of the SMBGs was 40.1-45.7 mg/dL across all treatment arms in the trials. Significantly larger reductions in SD of SMBGs from baseline to end of treatment were observed with semaglutide 0.5 mg (estimated treatment difference range -3.23 to -3.94 mg/dL) and 1.0 mg (-4.09 to -7.35 mg/dL), vs. comparators (all comparisons p<0.01; Figure A). Changes in SD of SMBGs were closely aligned with changes in HbA1c from baseline (Figure B).

In summary, the reduction of within-day GV from baseline was significantly greater with OW semaglutide vs. all active comparators, supporting improvement in clinically relevant outcomes with semaglutide treatment in those with T2D.

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Disclosure

R. E. Pratley: Other Relationship; Self; Hanmi Pharmaceutical, Merck Sharp & Dohme Corp., Metavention, Monster Energy Company, Inc., Novo Nordisk, Pfizer Inc., Poxel SA, Sanofi, Scohia Pharma Inc., Sun Pharmaceutical Industries Ltd. V. R. Aroda: Consultant; Self; Applied Therapeutics, Duke, Novo Nordisk, Pfizer Inc., Sanofi, Employee; Spouse/Partner; Janssen, Merck, Research Support; Self; Applied Therapeutics, Eli Lilly and Company, Fractyl, Medpace, Medpace, Novo Nordisk, Premier, Sanofi, Stock/Shareholder; Spouse/Partner; Janssen, Merck. C. Hindsberger: Consultant; Self; Novo Nordisk A/S, Stock/Shareholder; Self; Novo Nordisk A/S, Stock/Shareholder; Spouse/Partner; Novo Nordisk A/S. Y. Kose: Employee; Self; Novo Nordisk A/S. M. Kaltoft: Employee; Self; Novo Nordisk A/S, Stock/Shareholder; Self; Novo Nordisk A/S. E. Jodar: Other Relationship; Self; AstraZeneca, Lilly Diabetes, Mundipharma International, Novo Nordisk, Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH.

Funding

Novo Nordisk A/S

© 2021 by the American Diabetes Association
2021
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