THE EFFICACY AND SAFETY OF SEMAGLUTIDE IN GLYCEMIC CONTROL, WEIGHT REDUCTION, AND CARDIOVASCULAR RISK MANAGEMENT IN TYPE 2 DIABETES PATIENTS: A SYSTEMATIC REVIEW

Abstract

Background: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), has been increasingly utilized for the management of type 2 diabetes mellitus (T2DM) due to its dual action on glycemic control and weight reduction, with potential cardiovascular benefits.

Objective: To systematically evaluate the efficacy and safety of semaglutide—both subcutaneous and oral formulations—in improving glycemic control, reducing body weight, and mitigating cardiovascular risks among adults with T2DM.

Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Eligible studies included randomized controlled trials, observational studies, and meta-analyses published in English between 2015 and 2025, focusing on semaglutide's clinical outcomes. Databases searched included PubMed, Scopus, Web of Science, Embase, and Google Scholar. Outcomes evaluated included changes in HbA1c, body weight, major adverse cardiovascular events (MACE), and adverse event profiles.

Results: Thirty-five studies met the inclusion criteria. Semaglutide consistently demonstrated a significant reduction in HbA1c (up to 1.8%) and body weight (up to 6.9 kg). Cardiovascular outcome trials and post hoc analyses showed meaningful reductions in MACE, particularly in high-risk populations. The most common adverse effects were gastrointestinal in nature but were generally transient and dose-dependent. Real-world evidence confirmed these outcomes across diverse populations and care settings.

Conclusion: Semaglutide offers substantial clinical benefits in T2DM management by delivering robust glycemic control, effective weight loss, and cardiovascular protection. Its efficacy and tolerability profile support its inclusion as a preferred therapy in modern diabetes guidelines, though continued monitoring of long-term safety is necessary.