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. 2022 Jan 7;23(3):521–539. doi: 10.1007/s11154-021-09699-1

Table 4.

Indications for Semaglutide (As per American Diabetes Association 2020)

Semaglutide
Efficacy High
Cost High
Oral/Injectable Both available
Weight loss Yes
Risk of Hypoglycaemia No Semaglutide monotherapy
Yes Combination with insulin or other hypoglycaemic drugs; needs dose reduction
Cardiovascular risk Reduces cardiovascular risk
Need for dose adjustment in geriatrics, renal and hepatic impairment Not necessary
Preferred conditions

Requirement of greater glycaemic control

Need for injectable therapy to reduce HbA1c

Need to switch from injectable to oral therapy

If possible, preferred over insulin

In cardiovascular diseases of atherosclerotic origin and renal impairment

Intolerance to SGLT-2 inhibitors

Weight reduction is essential

Precautions

Avoid in- Medullary carcinoma of thyroid, Pancreatitis,

Multiple Endocrine Neoplasia Syndrome type 2,

Progressive retinopathy,

Congestive Heart Failure (As per EMA)