Prediabetes occurs when blood sugar levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. This condition increases the risk of developing full-blown type 2 diabetes and related complications affecting the heart, blood vessels, and kidneys. Early intervention can significantly reduce this progression.
Semaglutide is a medication primarily used for managing type 2 diabetes and supporting weight management. While not explicitly approved for prediabetes, its mechanisms of action and effects on the body are relevant to addressing the underlying metabolic issues seen in prediabetes.
How Semaglutide Works
Semaglutide belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. It functions by mimicking the natural GLP-1 hormone, which the body releases after eating. This mimicry triggers several actions that collectively help regulate blood sugar levels and influence appetite.
The medication stimulates the pancreas to release more insulin when blood sugar levels are high, which helps move glucose from the bloodstream into cells. It also reduces the secretion of glucagon, a hormone that signals the liver to produce and release stored sugar. Semaglutide further slows down gastric emptying, meaning food stays in the stomach longer, contributing to a feeling of fullness and reducing overall calorie intake. These combined effects help to lower blood sugar and can lead to weight loss.
Semaglutide’s Impact on Prediabetes
Semaglutide addresses metabolic imbalances in prediabetes, benefiting blood sugar control and weight management. It effectively lowers blood sugar levels and improves glycated hemoglobin (HbA1c), a measure of average blood sugar over several months.
The medication also promotes significant weight loss, which plays a substantial role in managing and potentially reversing prediabetes. Studies have shown that semaglutide can lead to an average weight loss of approximately 15% over 68 weeks when combined with lifestyle interventions. Losing even a small percentage of body weight, such as 5% to 7%, can significantly reduce the risk of type 2 diabetes progression.
Clinical trials, such as the STEP and SELECT programs, provide insights into semaglutide’s effects on prediabetes. In STEP 1, 3, and 4 trials, a large proportion of participants with prediabetes achieved normal blood sugar levels after 68 weeks of treatment. For instance, in STEP 1, 84.1% on semaglutide achieved normoglycemia, compared to 47.8% on placebo. The SELECT trial, which included individuals with cardiovascular disease and overweight or obesity, demonstrated that semaglutide reduced the risk of developing type 2 diabetes by 73%. These findings suggest semaglutide’s effects on weight and blood sugar can help prevent progression from prediabetes to type 2 diabetes.
Important Considerations for Semaglutide Use
Semaglutide is a prescription medication and requires ongoing medical supervision. Healthcare providers determine if it is an appropriate treatment based on an individual’s specific health profile. The medication is administered either as a once-weekly subcutaneous injection or a daily oral tablet. Injection sites typically include the abdomen, thigh, or upper arm, with rotation recommended to avoid irritation.
Common side effects associated with semaglutide often involve the digestive system, including nausea, vomiting, diarrhea, constipation, and abdominal pain. These effects are frequently most noticeable when treatment begins or after dose increases, and they tend to improve over several weeks as the body adjusts. Serious but less common side effects can include pancreatitis, gallbladder issues, and kidney damage.
The cost of semaglutide can vary significantly, ranging from approximately $800 to $1,500 per month without insurance for brand-name versions. Insurance coverage varies, but many plans cover it for type 2 diabetes, potentially reducing out-of-pocket costs. Semaglutide should always be part of a broader health management plan that includes lifestyle changes. Dietary modifications, such as reducing processed foods and increasing fiber intake, along with regular physical activity, are fundamental in managing prediabetes and are often recommended alongside medication.