Semaglutide is a modern oral medication used to manage type 2 diabetes mellitus (T2DM). A glucagon-like peptide-1 (GLP-1) receptor agonist, it mimics the body's natural GLP-1 hormone to help regulate blood sugar levels. Semaglutide increases insulin release, lowers excess glucagon, slows stomach emptying, and helps curb appetite. These actions make it particularly helpful for adults with T2DM who struggle with elevated blood sugar and excess body weight. When taken consistently, Semaglutide aids in blood sugar control, supports gradual weight loss, and promotes overall metabolic and heart health, with a generally good tolerability profile.

Semaglutide is a potent GLP-1 receptor agonist developed to support patients with type 2 diabetes. The 14 mg oral dose is the highest approved strength and is typically prescribed after stepwise dose escalation for patients who need additional glycaemic control. Unlike some oral antidiabetic drugs that act independently of insulin, Semaglutide works in harmony with the body's natural glucose regulation.

Semaglutide helps lower fasting and post-meal blood sugar levels and significantly reduces HbA1c. By delaying gastric emptying and acting on brain centres that control appetite, it promotes early satiety and reduces caloric intake, thereby supporting gradual, sustained weight loss. This is particularly beneficial for individuals with obesity, insulin resistance, or metabolic syndrome.

In addition to managing blood sugar, Semaglutide provides broader metabolic benefits, such as improvements in cardiometabolic risk factors. Its glucose-dependent mechanism of action reduces the risk of hypoglycaemia, whether used alone or with other non-insulin therapies, making it suitable for long-term management of type 2 diabetes.

Semaglutide is prescribed for managing metabolic conditions related to impaired blood sugar control. Its main uses include:

1. Type 2 Diabetes (T2DM): Helps adults achieve better blood sugar control when Diet, exercise, or other oral medications are not enough.

2. Persistent High Blood Sugar: Recommended for patients who do not reach target HbA1c levels with lower doses of Semaglutide or other therapies.

3. Overweight or Obese Adults with T2DM: Supports weight management while improving glycaemic control.

4. Insulin Resistance and Metabolic Syndrome: Enhances insulin sensitivity and helps balance other metabolic risk factors as part of a comprehensive treatment plan.

Benefits of Semaglutide

• Effective Blood Sugar Control: Helps lower blood glucose levels and supports sustained HbA1c reduction over time.
• Gradual Weight Management: Reduces appetite and caloric intake, supporting gradual, sustainable weight loss.
• Low Risk of Low Blood Sugar: Because it acts in a glucose-dependent manner, the risk of hypoglycaemia is minimal.
• Supports Heart and Metabolic Health: Improves key metabolic markers and may reduce long-term cardiovascular risks.
• Convenient Oral Dosing: Taken once daily, avoiding injections and improving ease of use and adherence.

Semaglutide is generally well tolerated, with most side effects being mild to moderate and temporary.

Common Side Effects:

1. Nausea

2. Vomiting

3. Diarrhoea

4. Constipation

5. Stomach discomfort or bloating

Less Common Side Effects:

1. Reduced appetite

2. Indigestion or heartburn

3. Fatigue or dizziness

Serious Side Effects (Seek medical attention immediately):

1. Severe and persistent abdominal pain, which may indicate pancreatitis

2. Symptoms of gallbladder issues, such as upper abdominal pain or yellowing of the skin/eyes (jaundice)

3. Severe dehydration from prolonged vomiting or diarrhoea

• Dosage: The usual maintenance dose is once daily, typically prescribed after gradually increasing from lower doses to ensure tolerance.
• Administration: Swallow the tablet whole with plain water. Do not crush or chew.
• Timing: Take the medication on an empty stomach at least 30 minutes before your first meal, beverage, or other oral medications of the day.
• Consistency and Monitoring: Daily adherence is essential for optimal blood sugar control. Regular monitoring of blood glucose and HbA1c is recommended to assess effectiveness and safety.

Semaglutide is a GLP-1 receptor agonist that targets both blood sugar regulation and appetite control, providing a holistic metabolic benefit.

GLP-1 Mediated Actions:

1. Stimulates insulin secretion only when blood glucose levels are elevated, reducing the risk of hypoglycemia.

2. Suppresses inappropriate glucagon release, which decreases glucose production by the liver.

3. Slows down gastric emptying, helping prevent post-meal blood sugar spikes.

4. Acts on brain centres that control hunger, leading to reduced appetite and lower food intake.

Metabolic Benefits:

1. Enhances insulin sensitivity and promotes efficient glucose utilization.

2. Supports gradual and sustainable weight loss through appetite regulation and caloric control.

3. Helps maintain long-term glycaemic stability, contributing to better overall diabetes management.

1. Take Semaglutide exactly as prescribed, always on an empty stomach.

2. Do not crush, split, or chew the tablet.

3. Eat smaller, balanced meals to minimise nausea.

4. Stay well hydrated, especially during the first few weeks of therapy.

5. Combine medication with healthy lifestyle practices, including Diet and exercise, for optimal results.

1. Keep Semaglutide tablets at a temperature below 30°C.

2. Protect the medication from moisture and direct sunlight to maintain effectiveness.

3. Store in a safe place out of the reach of children.

• Food: Semaglutide should always be taken on an empty stomach to ensure proper absorption and maximum effectiveness.
• Alcohol: Excessive alcohol consumption may increase the likelihood of nausea and dehydration, so it should be limited or avoided.

• Insulin or Sulfonylureas: Combining with these medications may increase the risk of low blood sugar, so dose adjustments may be necessary.
• Other Oral Medications: Slower gastric emptying can affect the timing of absorption for some oral drugs, so that spacing doses may be recommended.

• History of Pancreatitis: Use with caution under close medical supervision, as it may exacerbate pancreatic issues.
• Severe Gastrointestinal Conditions: Patients with existing GI disorders should monitor for worsening symptoms.
• Severe Kidney Impairment: Close monitoring is advised due to an increased risk of dehydration from side effects like vomiting or diarrhoea.

The standard maintenance dose is 14 mg once daily, taken under the guidance of a healthcare professional. Dose adjustments should only be made by a doctor based on individual response and tolerance.

Possible Symptoms: Severe nausea, vomiting, or diarrhoea may occur if an overdose is taken.

What to Do: Seek immediate medical advice for supportive care and monitoring.

1. If you miss a dose, skip it and take the next scheduled dose the following day.

2. Do not take two doses at the same time to make up for a missed tablet, as this may increase side effects.