What is Semaglutide?
It is NOT your mother’s “diet pill.
Semaglutide is a recombinant DNA produced polypeptide analogue of human glucagon-like peptide-1 (GLP-1) which is used in combination with diet and exercise in the therapy of type 2 diabetes, either alone or in combination with other antidiabetic agents. There have been no published reports of hepatotoxicity attributed to semaglutide therapy.Semaglutide is a polypeptide that contains a linear sequence of 31 amino acids joined together by peptide linkages. It is an agonist of glucagon-like peptide-1 receptors (GLP-1 AR) and used for the treatment of type 2 diabetes. It has a role as a hypoglycemic agent, a glucagon-like peptide-1 receptor agonist, an anti-obesity agent, a neuroprotective agent and an appetite depressant. It is a polypeptide and a lipopeptide.Obesity is a global health challenge with few pharmacologic options. Whether adults with obesity can achieve weight loss with once-weekly semaglutide at a dose of 2 mg as an adjunct to lifestyle intervention has not been confirmed. Semaglutide (Glucagon-Like Peptide-1) OverviewSemaglutide, GLP-1, short for glucagon-like peptide-1 is a short, naturally occurring peptide hormone just 30-31 amino acids in length. Its primary physiologic function is to lower blood sugar levels by naturally enhancing insulin secretion. It also plays roles in protection beta cell insulin stores by promoting insulin gene transcription and has been linked with neurotrophic effects in the brain and central nervous system.In the GI system, GLP-1 has been shown to significantly decrease appetite by delaying gastric emptying and reducing intestinal motility. Preliminary research has shown impacts of GLP-1 in the heart, fat, muscles, bones, liver, lungs, and kidneys as well.The primary focus of GLP-1 research has been in the realm of diabetes treatment/prevention as well as appetite suppression. Secondary research focuses on the potential cardiovascular benefits of the peptide. More recent, and thus less robust, research focuses on the ability of GLP-1 to stave off neurodegenerative disease. Though this latter area of research is newest, it is also the fast-growing area of GLP-1 study now that the peptide has been revealed to slow or prevent the accumulation of amyloid beta plaques in the setting of Alzheimer’s disease.Semaglutide is a glucagon-like peptide-1 receptor agonist. It increases the production of insulin, a hormone that lowers the blood sugar level. It also appears to enhance growth of β cells in the pancreas, which are the sites of insulin production.In short, it inhibits glucagon, which is a hormone that increases blood sugar. It additionally reduces food intake by lowering appetite and slows down digestion in the stomach. In this way it reduces body fat. Semaglutide GLP-1 researchThe Incretin Effect of GLP-1Perhaps the most important effect that GLP-1 has, according to Dr. Holst, is referred to as the “incretin effect.” Incretins are a group of metabolic hormones, released by the GI tract, that cause a decrease in blood glucose (sugar) levels. GLP-1 has been shown to be one of the two most important hormones (the other being GIP) to stimulate the incretin effect in rodent models. Though GIP circulates at levels roughly 10 times higher than that of GLP-1, there is evidence that GLP-1 is the more potent of the two molecules, particularly when levels of blood glucose are quite high.A GLP-1 receptor has been identified on the surface of pancreatic beta cells, making it clear that GLP-1 directly stimulates the exocytosis of insulin from the pancreas. When combined with sulfonylurea drugs, GLP-1 has been shown to boost insulin secretion enough to cause mild hypoglycemia in up to 40% of subjects[1]. Of course, increased insulin secretion is associated with a number of trophic effects including increased protein synthesis, reduction in the breakdown of protein, and increased uptake of amino acids by skeletal muscle. GLP-1 and Beta Cell ProtectionResearch in animal models suggests that GLP-1 can stimulate the growth and proliferation of pancreatic beta cells and that it may stimulate the differentiation of new beta cells form progenitors in the pancreatic duct epithelium. Research has also shown that GLP-1 inhibits beta cell apoptosis. Taken in sum, these effects tip the usual balance of beta cell growth and death toward growth, suggesting that the peptide may be useful in treating diabetes and in protecting the pancreas against insult that harms beta cells.In one particularly compelling trial, GLP-1 was shown to inhibit the death of beta cells caused by enhanced levels of inflammatory cytokines. In fact, mouse models of type 1 diabetes have revealed that GLP-1 protects islet cells from destruction and may, in fact, be a useful means of preventing onset of the type 1 diabetes. GLP-1 and AppetiteResearch in mouse models suggests that administration of GLP-1, and its similar cousin GLP-1, into the brains of mice can reduce the drive to eat and inhibit food intake. It appears that GLP-1 may actually enhance feelings of satiety, helping individuals to feel fuller and reducing hunger indirectly. Recent clinical studies have shown in mice that twice daily administration of GLP-1 receptor agonists cause gradual, linear weight loss. Over a long period, this weight loss is associated with significant improvement in cardiovascular risk factors and a reduction in hemoglobin A1C levels, the latter of these being a proxy marker for the severity of diabetes and the quality of blood sugar control attained via treatment. Potential Cardiovascular Benefits of GLP-1It is now know that GLP-1 receptors are distributed throughout the heart and act to improve cardiac function in certain settings by boosting heart rate and reducing left ventricular end-diastolic pressure. The latter may not seem like much, but increased LV end-diastolic pressure is associated with LV hypertrophy, cardiac remodeling, and eventual heart failure.Recent evidence has even suggested that GLP-1 could play role in decreasing the overall damaged caused by a heart attack. It appears that the peptide improves cardiac muscle glucose uptake, thereby helping struggling ischemic heart muscle cells to get the nutrition they need to continue functioning and avoid programmed cell death. The increase in glucose uptake in these cells appears to independent of insulin.Large infusions of GLP-1 into dogs have been shown to improve LV performance and reduce systemic vascular resistance. The latter effect can help to reduce blood pressure and ease strain on the heart as a result. This, in turn, can help to reduce the long-term consequences of high blood pressure such as LV remodeling, vascular thickening, and heart failure. According to Dr. Holst, administration of GLP-1 following cardiac injury has “constantly increased myocardial performance both in experimental animal models and in patients.” GLP-1 and the BrainThere is some evidence to suggest that GLP-1 can improve learning and help to protect neurons against neurodegenerative diseases such as Alzheimer’s disease. In one study, GLP-1 was shown to enhance associative and spatial learning in mice and even to improve learning deficits in mice with specific gene defects. In rats that over-express the GLP-1 receptor in certain regions of the brain, learning and memory are both significantly better than in their normal controls.Additional research in mice has shown that GLP-1 can help to protect against excitotoxic neuron damage, completely protecting rat models of neurodegeneration against glutamate-induced apoptosis. The peptide can even stimulate neurite outgrowth in cultured cells. Researchers are hopeful that additional research on GLP-1 will reveal how it might be used to halt or reverse certain neurodegenerative diseases.Interestingly, GLP-1 and its analogue exendin-4 have been shown in mouse models to reduce levels of amyloid-beta in the brain as well as the beta-amyloid precursor protein found in neurons. Amyloid beta is the primary component of the plaques observed in Alzheimer’s disease, plaques which, while not necessarily known to be causative, are associated with the severity of the disease. It remains to be seen if preventing amyloid beta accumulation can protect against the effects of Alzheimer’s disease, but this research is, at the very least, a tantalizing clue as to how scientists my intervene in the progression of mild cognitive impairment to full Alzheimer’s disease.GLP-1 exhibits minimal to moderate side effects, low oral and excellent subcutaneous bioavailability in mice. Per kg dosage in mice does not scale to humans. Semaglutide Questions• How to use semaglutide for weight loss?Taking 2.4 Mg/0.75 Ml Subcutaneous Pen Injector as example, inject this medication under the skin in the thigh, abdomen, or upper arm as directed by your doctor, usually once weekly. It may be used with or without food. The dosage is based on your medical condition and response to treatment. Your doctor will start you on a low dose first to decrease your risk of stomach/abdominal side effects, and gradually increase your dose. Follow your doctor’s instructions carefully.Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. Do not inject in an area that is tender, bruised, red, hard, or has scars or stretch marks.Use this medication regularly to get the most benefit from it. To help you remember, use it on the same day and time each week. It may help to mark your calendar with a reminder. Carefully follow the meal plan and exercise program your doctor has recommended. Learn how to store and discard medical supplies safely. • How does semaglutide burn fat?Patients can lose significant weight on semaglutide because it suppresses appetite. Semaglutide can be taken orally or by injection, according to Novo Nordisk, and it works by increasing the production of insulin, a hormone produced by the pancreas that helps regulate blood sugar. What are the side effects of semaglutide?Semaglutide injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: nausea. vomiting. diarrhea. abdominal pain. constipation. heartburn. burping. Does semaglutide cause hair loss?No, hair loss wasn’t reported as a side effect by people taking Ozempic in clinical studies. But hair loss and hair thinning may occur in people who have diabetes and consistently high blood sugar levels. If you have questions about hair loss, talk with your doctor or pharmacist. How quickly do you lose weight with semaglutide?Despite the promising research, there’s one major caveat to the medication: in order to keep the weight off, patients need to continue taking it. One recent study showed that patients on semaglutide lost 10% of their body weight in 20 weeks, but regained nearly all of it after the treatment. How long do you stay on semaglutide?Most patients will start semaglutide treatment at the lower 0.25 mg dose injected once a week for 4 weeks. The 0.25 mg dose is not used as your final maintenance dose to lower your blood sugar. Where do you inject semaglutide?If you will be using semaglutide at home, your doctor will teach you how the injections will be given. Be sure you understand exactly how the medicine is to be injected. This medicine is given as a shot under the skin of your stomach, thighs, or upper arm. Use a different body area each time you give yourself a shot. Does semaglutide make tired?Swelling/redness/itching at the injection site, tiredness, nausea, vomiting, diarrhea, or constipation may occur. Nausea usually lessens as you continue to use semaglutide. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Other adverse reactions with a frequency of >0.4% were associated with OZEMPIC include fatigue, dysgeusia and dizziness. What happens when you stop semaglutide?Continuation of semaglutide after 20 weeks of initial therapy leads to significant continued weight loss, according to a new study, but stopping the therapy causes patients to regain much of the weight they initially lost. Is semaglutide safe long term?The study demonstrates that long-term use of oral semaglutide with flexible dose adjustment results in durable improvements in glycemic control and further reductions in body weight and is generally well tolerated.