Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;27(4):1805-1814.
doi: 10.1111/dom.16174. Epub 2025 Jan 10.

Real-world retrospective study in elderly patients aged 65 years and older with type 2 diabetes mellitus treated with daily oral semaglutide (SEMA-elderly)

Vincenzo Fiore  1 , Giovanni Carbotta  1 , Sonia Barraco  1 , Paolo Falasca  2 , Concetta Nadia Aricò  3 , Alessandra Barucca  1
Affiliations

Real-world retrospective study in elderly patients aged 65 years and older with type 2 diabetes mellitus treated with daily oral semaglutide (SEMA-elderly)

Vincenzo Fiore et al. Diabetes Obes Metab. 2025 Apr.

Abstract

Aim: This real-world, retrospective cohort study aimed to assess the efficacy, safety and tolerability of oral semaglutide-the first GLP-1 receptor agonist available in oral form-in patients aged 65 years and older with type 2 diabetes mellitus (T2DM).

Materials and methods: The primary endpoint was the change in glycated haemoglobin (HbA1c) from baseline (V1) to six months (V3). Secondary endpoints included change in body weight, proportion of patients achieving HbA1c <7%, proportion of patients achieving both an HbA1c reduction of ≥1% and a body weight reduction of ≥5%. Exploratory endpoints were also assessed, including evaluations at three months (V2).

Results: One hundred and one patients (mean age 74.7 ± 6.1 years) started oral semaglutide treatment. Mean HbA1c decreased significantly from V1 to V3 (change: -0.44%, p < 0.001), with reductions already evident at V2. The proportion of patients achieving an HbA1c ≤7% increased from 36.6% at V1 to 61.7% at V3. At V3, 9.6% of patients achieved an HbA1c reduction of ≥1% and a weight loss of ≥5%. Body weight decreased from a baseline mean of 76.8-73.7 kg at V3 (p < 0.001). Body mass index, waist circumference, total cholesterol, low-density lipoprotein cholesterol and systolic blood pressure decreased significantly from V1 to V3, with changes already evident at V2. Eleven patients (10.9%) reported adverse events. Seven patients (6.9%) discontinued treatment.

Conclusion: Oral semaglutide effectively improves glycaemic control and weight management in elderly patients with T2DM while improving lipid and cardiovascular parameters and proving to be safe and well tolerated.

Keywords: GLP‐1 receptor agonist; HbA1c; glycaemic control; real‐world evidence; semaglutide; type 2 diabetes.

PubMed Disclaimer

References

REFERENCES

    1. Ahrén B. Glucagon‐like peptide‐1 receptor agonists for type 2 diabetes: a rational drug development. J Diabetes Investig. 2019;10(2):196‐201. doi:10.1111/jdi.12911
    1. Lyseng‐Williamson KA. Glucagon‐like Peptide‐1 receptor agonists in type 2 Diabetes: their use and differential features. Clin Drug Investig. 2019;39(8):805‐819. doi:10.1007/s40261‐019‐00826‐0
    1. Andersen A, Knop FK, Vilsbøll T. A pharmacological and clinical overview of Oral Semaglutide for the treatment of type 2 Diabetes. Drugs. 2021;81(9):1003‐1030. doi:10.1007/s40265‐021‐01499‐w
    1. Sharma A, Verma S. Mechanisms by which glucagon‐like‐Peptide‐1 receptor agonists and sodium‐glucose Cotransporter‐2 inhibitors reduce cardiovascular risk in adults with type 2 Diabetes mellitus. Can J Diabetes. 2020;44(1):93‐102. doi:10.1016/j.jcjd.2019.09.003
    1. Levin PA, Nguyen H, Wittbrodt E, Kim SC. Glucagon‐like peptide‐1 receptor agonists: a systematic review of comparative effectiveness research. DMSO. 2017;10:123‐139. doi:10.2147/DMSO.S130834

MeSH terms