PIONEER REAL Saudi Arabia: A multicentre, prospective, real‐world study of once‐daily oral semaglutide use in adults with type 2 diabetes in Saudi Arabia

Nov 27, 2025Diabetes, obesity & metabolism

Daily oral semaglutide use in adults with type 2 diabetes in Saudi Arabia: a real-world study

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Abstract

In a study of 192 adults with type 2 diabetes, mean glycated hemoglobin (HbA1c) decreased by 1.0%-point after treatment with oral semaglutide.

Mean body weight decreased by 4.4 kg, and waist circumference decreased by 4.3 cm.
At the end of the study, 61.9% of participants achieved HbA1c levels below 7%.
21.9% of participants had HbA1c reductions of at least 1% along with body weight reductions of at least 3%.
Treatment satisfaction significantly improved, with mean changes in satisfaction scores indicating greater contentment with the treatment.
49.5% of participants remained on oral semaglutide at the end of the study, with a majority on the 14.0 mg dose.

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AIM: PIONEER REAL Saudi Arabia investigated real-world clinical outcomes associated with the use of once-daily oral semaglutide in adults with type 2 diabetes (T2D).

MATERIALS AND METHODS: This was a 34- to 44-week multicentre, prospective, open-label study in adults with T2D, who were treatment-naive to injectable glucose-lowering medication and initiated oral semaglutide in routine clinical practice. The primary endpoint was change from baseline to end of study (EoS) in glycated haemoglobin (HbA1c). Secondary and exploratory endpoints included changes in body weight (BW) and waist circumference (WC) from baseline to EoS. Treatment satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire-status (DTSQs) and change (DTSQc) tools.

RESULTS: In total, 192 participants initiated oral semaglutide. At baseline, mean (standard deviation) age was 51.7 (10.91) years, mean HbA1c was 8.0% (1.51) and mean BW was 90.5 kg (15.68). In total, 139 participants completed the study. Estimated mean (standard error [SE]) changes (95% confidence interval) in HbA1c and BW were -1.0%-points (0.09; p < 0.0001) and -4.4 kg (0.51; p < 0.0001), respectively. Estimated mean (SE) change in WC was -4.3 cm (0.62; p < 0.0001). At EoS, 61.9% of participants had HbA1c levels <7%, with 21.9% and 17.1% achieving HbA1c reductions of ≥1% alongside BW reductions of ≥3% or ≥5%, respectively. Treatment satisfaction increased significantly (mean change in DTSQs +8.7 and DTSQc 14.9; both p < 0.0001). At EoS, 49.5% of participants remained on oral semaglutide, of whom 47.4% were receiving the 14.0 mg dose.

CONCLUSIONS: This real-world population of adults with T2D in Saudi Arabia experienced clinically significant reductions in HbA1c and BW, increased treatment satisfaction and a favourable safety profile, consistent with previously published PIONEER REAL studies.

Key numbers

-1.0%

HbA1c Reduction

Change in HbA1c from baseline to EoS.

-4.4 kg

Body Weight Reduction

Change in body weight from baseline to EoS.

8.7 points

Treatment Satisfaction Increase

Change in Diabetes Treatment Satisfaction Questionnaire score from baseline to EoS.

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PIONEER REAL Saudi Arabia: A multicentre, prospective, real‐world study of once‐daily oral semaglutide use in adults with type 2 diabetes in Saudi Arabia

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