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How Semaglutide Effects Blood Sugar

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How Semaglutide Effects Blood Sugar

— By Dawn Sweet, Ph.D.

Semaglutide lowers blood sugar and helps HbA1c levels drop to preferred ranges for patients with type 2 diabetes.  

Semaglutide, a synthetic form of the glucagon-like peptide 1 (GLP-1) hormone, is implicated in the regulation of blood glucose. Semaglutide increases insulin, which in turn decreases how much glucose enters the bloodstream. The effects of semaglutide on blood glucose is amplified because of its effectiveness for weight loss because of its appetite suppressing effect.1,2

Does Semaglutide Lower Blood Sugar?

A 26-week randomized, parallel-group phase 2 trial compared dosage-response on glycemic control with once-daily oral semaglutide and once-weekly subcutaneous semaglutide.2 Each form of semaglutide was compared with a placebo. Oral semaglutide dosage groups were 2.5, 5, 10, 20, and 40 mgs. Subcutaneous semaglutide was dosed at 1 mg per week. Participants (n = 630; Mage = 57.1) were ³ 18 type 2 diabetics with poor glycemic control (HbA1c = 7.0 – 9.5 percent) and a BMI of 25 – 40 kg/m2. The outcome measure was the mean change of HbA1c from baseline.

Oral semaglutide significantly reduced HbA1c in the treatment groups by week 26 compared to the placebo group. A significant decrease HbA1c was also observe in the subcutaneous semaglutide group by week 26. Overall, oral semaglutide yielded improved glycemic control compared to subcutaneous semaglutide. The target HbA1c level of < 7.0 percent was observed in 44 percent of participants in the 2.5 mg dosage and in 90 percent of participants at the 40 mg standard dosage. Seventy-one percent of participant in the oral semaglutide group achieved clinically relevant weight loss, ³ 5 percent. Despite the results, the author caution that the trial period was relatively brief, and that future research should consider extending the trial period to further explore the effects of oral and subcutaneous semaglutide on HbA1c levels.

Physical Activity, Nutrition and Semaglutide

Evidence is mounting for the use of semaglutide to help patients with type 2 diabetes reach normoglycemic ranges and to achieve clinically significant weight loss. The weight loss associated with semaglutide no doubt contributes to the improvements in glycemic control. As blood glucose levels become stable and patients lose weight, they are better positioned to pursue an active lifestyle that includes daily physical activity.

Physical activity in support of weight loss and weight maintenance needs to be buttressed by nutrition, particularly when taking semaglutide. Supporting patients’ nutritional needs while on semaglutide is important because of its appetite suppressing effect. While on semaglutide, patients’ energy intake is decreased3,4, so optimizing nutrition at every meal warrants attention.  When working with patients to develop a nutritionally balanced eating plan, including nutritionally designed meal replacements will support a balanced diet where the RDA for protein, fiber, vitamins, and minerals are achieved. Additionally, nutritionally designed meal replacements can help semaglutide patients manage the associated GI side effects.


1 Effects of glucagon-like peptide-1 receptor agonists on weight loss: Systematic review and meta-analyses of randomized controlled trials

2 Effect of oral semaglutide compared with placebo and subcutaneous semaglutide on glycemic control in patients with type 2 diabetes: A randomized clinical control trial

3 The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity

4 Does intervention with GLP-1 receptor agonist Semaglutide modulate perception of sweet taste in women with obesity: Study protocol of a randomized, single-blind, placebo-controlled clinical trial

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.

About Robard: For 45 years, Robard Corporation’s medical obesity treatment programs and nutrition products have been utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at, email us at, or call (800) 222-9201.

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