Semaglutide

Semaglutide is a synthetic analog of the naturally occurring human gut hormone GLP-1.⁴ By selectively binding to and activating the GLP-1 receptor, it mimics the hormone’s actions to regulate blood sugar and appetite.

Key Mechanism of Action:

• Glucose-Dependent Insulin Secretion: Stimulates the pancreas to release more insulin only when blood sugar levels are high, minimizing the risk of severe hypoglycemia.
• Glucagon Suppression: Reduces the secretion of glucagon, a hormone that raises blood sugar.
• Gastric Emptying Delay: Slows down the rate at which food leaves the stomach, which helps dampen post-meal blood sugar spikes.
• Appetite and Satiety Regulation: Acts on the appetite centers in the brain (hypothalamus) to increase the feeling of fullness (satiety) and reduce food intake, leading to substantial and sustained weight loss.

Approved Indications:

1. Type 2 Diabetes Mellitus (T2DM): Used as an adjunct to diet and exercise to improve blood sugar control.
2. Cardiovascular Risk Reduction: Indicated to reduce the risk of major adverse cardiovascular events (like heart attack, stroke, or cardiovascular death) in adults with T2DM and established cardiovascular disease.
3. Chronic Weight Management: Used with diet and exercise for long-term weight management in adults and adolescents with obesity (BMI ¹¹$\ge 30$ kg/m$^2$) or overweight (BMI ¹²$\ge 27$ kg/m$^2$) with at least one weight-related comorbidity.

Dosage Forms and Brands:

• Injection (Once-Weekly): Sold under the brand names Ozempic® (primarily T2DM) and Wegovy® (primarily chronic weight management).¹⁴
• Oral Tablet (Once-Daily):¹⁵ Sold under the brand name Rybelsus® (T2DM).