The use of semaglutide as an add-on therapy in patients with latent autoimmune diabetes in adults

Introduction: Semaglutide, a GLP-1R agonist (GLP-1RA), has demonstrated high efficacy in the management of type 2 diabetes (T2D). Few data in literature are available regarding the use of this agent in patients affected by latent autoimmune diabetes in adult (LADA). The purpose of this study is to analyze the efficacy of semaglutide use in patients affected by LADA. Materials and methods: In this retrospective study we collected and analyzed data of 80 patients with LADA treated with semaglutide, either oral or subcutaneous, as an add-on therapy to insulin. Laboratory and clinical parameters and metrics from continuous glucose monitoring were collected where available. Results: Among 80 patients, 68 subjects continued semaglutide (57/68 oral and 11/68 subcutaneous) for at least 6 months, while 12/80 patients discontinued the treatment. After 6 months, semaglutide users showed statistically significant reduction in HbA1c, body-mass index (BMI) and in insulin total daily dose. Interestingly, serum C-peptide levels and the time-in-range values increased as well, without changes in the time-below-range. Subjects with residual β-cell function, showed a higher BMI and insulin total daily dose reduction. Moreover, the subgroup of subjects with preserved β-cell mass showed a greater improvement in time-in-range as compared to those with poor C-peptide production. Finally, 14/68 subjects suspended insulin bolus administration after starting semaglutide. Conclusion: Semaglutide as an add-on treatment to insulin exerted relevant clinical beneficial effects on the glycometabolic control in patients with LADA. These effects are enhanced in those patients with preserved β-cell function.