Journal of diabetes investigationDec 21, 2024

How well oral semaglutide works when added to or replacing other incretin drugs in type 2 diabetes

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jan 20, 2026

Abstract

Mean change in HbA1c levels was -0.85% in the incretin-related drug-naïve group after 6 months of oral semaglutide treatment.

Oral semaglutide led to a significant reduction in HbA1c levels compared to participants switching from other incretin-related drugs.
The mean change in HbA1c for those switching from DPP-4 inhibitors was -0.67%, while for GLP-1 receptor agonist switchers it was -0.13%.
Body weight changes were similar between the incretin-related drug-naïve and DPP-4 inhibitor groups, but were lower in the GLP-1 receptor agonist group.
In participants pre-treated with GLP-1 receptor agonists, there were no differences in HbA1c changes, but body weight loss was greater in the dulaglutide group compared to the injectable semaglutide group.

Simplified

AIMS/INTRODUCTION: This study aimed to evaluate and compare the effectiveness of oral semaglutide after adding to or switching from incretin-related drugs by assessing the changes in HbA1c and body weight (BW) in participants with type 2 diabetes in clinical settings.

MATERIALS AND METHODS: A total of 368 participants were divided into groups according to antidiabetic medications before oral semaglutide treatment; incretin-related drug-naïve (naïve), switching from dipeptidyl peptide-4 inhibitors (DPP-4i) or glucagon-like peptide-1 receptor agonist (GLP-1 RA) groups. Adjusted mean changes in HbA1c and BW at 6 months after oral semaglutide administration were compared among the three groups. Similar analyses were performed in the GLP-1 RAs group between GLP-1RAs before switching.

RESULTS: Mean change of HbA1c in DPP-4i and GLP-1 RA groups was -0.67% (95% confidence interval [CI]: -0.79 to -0.54) and -0.13% (95% CI: -0.40 to 0.15), respectively, which were significantly smaller than incretin-related drug-naïve group; -0.85% (95% CI: -1.08 to -0.62). Mean change in BW between the naïve and DPP-4i groups had no differences; however, these changes were lower in the GLP-1 RA group than in the naïve group. Mean change in HbA1c between pretreatment with GLP-1 RAs had no differences; however, the mean change in BW in the dulaglutide group was significantly higher than that in the injectable semaglutide group.

CONCLUSION: Oral semaglutide reduced HbA1c levels and BW after adding or switching from other incretin-related drugs in Japanese participants with type 2 diabetes.

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Funding

Competing interests

Nakagami received personal fees from Sanwa Kagaku Kenkyusho Co. Ltd., Novo Nordisk Pharma Ltd., Japan; Eli Lily Japan KK, Sanofi K.K., Sumitomo Pharma, and Boehringer Ingelheim Japan Inc. The authors declare no conflicts of interest. Approval of the research protocol: N/A. Informed consent: Informed consent was obtained from all study participants. Registry and registration no. of the study/trial: N/A. Animal studies: N/A.

PubMed

How well oral semaglutide works when added to or replacing other incretin drugs in type 2 diabetes

Abstract

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Competing interests

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Abstract

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