Being obese and overweight comes with several health consequences. For one, patients with obesity or overweight are at high risk for cardiovascular disorders. It can also lead to type 2 diabetes mellitus which can likewise make your heart health deteriorate. Fortunately, there are weight loss and diabetes medications that can help control your symptoms and lower your risk for CVD events. One such medication is semaglutide.
So how can semaglutide help improve your cardiovascular health? Semaglutide is indicated for the treatment of type 2 diabetes and has also recently been approved for chronic weight management with positive cardiovascular outcomes. Several studies report that once weekly semaglutide treatments can help reduce cardiovascular mortality and morbidity in diabetic and overweight patients by managing blood sugar and cholesterol levels.
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Semaglutide is a glucagon-like-peptide-1 receptor agonist (GLP 1 ra) which is a class of medications commonly used for blood sugar control. They're also known as incretin mimetics since they essentially mimic the action of naturally-occurring hormones that help release insulin to break down glucose for energy after a meal.
GLP-1 agonists can also help suppress appetite and minimize your cravings which can lead to a reduction in body weight. It helps slow down the gastric emptying process which can increase your satiety for longer periods of time. This also means that you’ll have less of a need to consume food and can help manage your blood sugar from increasing after eating.
The use of oral semaglutide for once daily medication in patients with type 2 diabetes. The treatment has also been approved for once weekly injections for chronic weight management in individuals with at least one weight-related condition or established cardiovascular disease.
Here are some of the studies that show the positive outcomes of semaglutide for managing a cardiovascular event:
The PIONEER trials, or Peptide Innovation for Early Diabetes Treatment, are a series of studies that aim to test the different effects and aspects of oral GLP-1 receptor agonist medications. It’s sponsored by Novo Nordisk, the manufacturer of semaglutide medication. Researchers conducted more than 10 trials under the series, and the cardiovascular outcomes of semaglutide were observed in the PIONEER 6 clinical trial.
PIONEER 6 is a randomized, placebo-controlled trial that’s designed to study the outcomes of semaglutide in patients with type 2 diabetes who are also at high risk for an adverse cardiovascular event. It studied participants who were more than 50 years of age with established CVD or chronic kidney disease.
During the trial duration, patients were randomly designated to receive either once daily oral semaglutide or placebo following a 1:1 ratio. The primary endpoint of the trial was to determine the noninferior cardiovascular outcome of semaglutide versus placebo. Here’s a table showing the occurrence of a specific adverse event during the trial:
|Oral semaglutide treatment||Placebo|
|Outcome||3.8% of 1591 patients experienced adverse cardiovascular effects||4.8% of 1592 patients experienced cardiovascular events|
|Cardiovascular death||Occurred in 0.9% patients in the semaglutide group||Occurred in 1.9% patients of the placebo group|
|Nonfatal myocardial infarction||Occurred in 2.3% patients||Occurred in 1.9% patients|
|Non-fatal stroke||Occurred in 0.8% patients||Occurred in 1.0% patients|
|Heart failure with hospitalization||Occurred in 1.3% patients||Occurred in 1.5% patients|
|Unstable angina with hospitalization||Occurred in 0.7% patients||Occurred in 0.4% patients|
Overall, the results point to a positive trend of oral semaglutide providing a significant reduction in serious cardiovascular issues. It also suggests that there's a low risk of all-cause mortality in patients taking oral semaglutide (1.45%) compared to those receiving placebo (2.83%).
SUSTAIN 6 is another randomized, placebo-controlled trial that aims to analyze the long-term cardiovascular safety and outcomes of semaglutide injections in type 2 diabetic patients. About 3297 participants who were currently undergoing standard diabetes care regimen were selected for the trial.
Following a 1:1:1 ratio, subjects were assigned to receive either 0.5mg or 1.0mg of once weekly semaglutide injection or placebo. The patients were then observed for a period of 109 weeks and monitored for any cardiovascular event or adverse side effect. Similar to PIONEER 6, the SUSTAIN semaglutide trial noted the incidence of CV outcomes among the patients.
Here’s a table showing the rate of occurrence of cardiovascular events in the semaglutide versus placebo group:
|Outcome||6.6% of 1648 patients experienced adverse cardiovascular effects||8.9% of 1649 patients experienced cardiovascular events|
|Cardiovascular death||Occurred in 2.7% patients in the semaglutide group||Occurred in 3.6% patients of the placebo group|
|Nonfatal myocardial infarction||Occurred in 2.9% patients||Occurred in 3.9% patients|
|Nonfatal stroke||Occurred in 1.6% patients||Occurred in 2.7% patients|
|Heart failure with hospitalization||Occurred in 3.6% patients||Occurred in 3.3% patients|
|Unstable angina with hospitalization||Occurred in 1.3% patients||Occurred in 1.6% patients|
Although cardiovascular events were still inevitable among the observed diabetic patients, the rate of incidence was significantly lower compared to those who received placebo. This suggests that once weekly subcutaneous semaglutide can also be helpful in reducing your CVD risk for severe cardiovascular outcomes.
GLP-1 receptor agonists have also shown positive effects in reducing the risk for atherosclerosis-related events. Atherosclerosis pertains to the accumulation of fats, cholesterol, and other harmful substances in and around the walls of the arteries. It’s one of the possible causes of mortality in diabetic patients.
According to a study, GLP-1 agonist drugs can help lower systolic blood pressure by about 2 to 6 mmHg. Atherosclerosis is one of the major complications of having high blood pressure, and taking semaglutide may help reduce the risk for this serious atherosclerotic vascular disease.
These medications also provide anti-inflammatory properties which can contribute to reduced atherosclerosis formation. By managing the inflammation of the arteries, it helps stabilize the plaque and improve the vascular cells to lower your risk for CV disease and atherosclerosis.
GLP-1 receptor agonists and SGLT 2 inhibitors also help manage serum levels of cholesterol in diabetic and overweight patients. They’ve both shown positive outcomes in reducing LDL cholesterol and improving total lipid profile which suggests beneficial effects for diabetes and body weight management.
Semaglutide also offers some metabolic effects which are helpful in reducing your overall fat and improving your weight and body composition. A study has observed that higher doses of semaglutide may provide around 10% to 20% weight reduction which contributes to lesser possibilities of atherosclerotic cardiovascular disease.
Type 2 diabetes, obesity, and heart health are almost always associated together. In diabetic patients, the risk for CV events comes from the fact that elevated blood sugar levels can damage the blood vessels and nerves surrounding the heart. Having a history of high blood pressure or high cholesterol in the family may also make you more vulnerable to a cardiovascular disorder since the increased force of blood flow or plaque buildup can damage the artery walls.
In the past years, researchers have found that cardiovascular events are one of the major causes of mortality in patients with type 2 diabetes. A study shows that CVD affects about 32.2% of individuals with diabetes mellitus and cardiovascular death is prevalent in around 9.9% of diabetic patients.
Per the results of PIONEER 6 trials, oral semaglutide offers promise in providing cardiovascular benefit and reducing the incidence of mortality by about 50%. SUSTAIN 6 also shows that subcutaneous semaglutide can help manage your diabetes condition with very minimal CV risk.
Patients with type 2 diabetes are twice as likely to develop heart failure than an individual without diabetes. This condition occurs when the heart becomes unable to pump oxygen-rich blood throughout the body. Being obese or overweight may also affect your cardiovascular function and cause structural changes that may lead to heart failure.
Fortunately, both once daily oral and once weekly subcutaneous semaglutide is proven safe for treating diabetes and promoting weight loss as seen in accessible studies. The medication may help preserve your cardiovascular health and function, which can contribute to a reduced risk for heart failure.
Although several studies have backed the clinical safety and efficacy of semaglutide treatment, some minor side effects have also been reported with the medication. The possible reactions vary depending on the method in which semaglutide was administered. Here's an overview of the potential side effects that may happen with oral and subcutaneous semaglutide:
|Oral Semaglutide||Subcutaneous Semaglutide|
|Loss of appetite||Some gastrointestinal problems like diarrhea, vomiting, and constipation|
|Gastrointestinal issues such as nausea, vomiting, diarrhea, constipation, flatulence, and dyspepsia||Bloating|
|Abdominal pain and bloating||Stomach pain or fullness|
|Hypoglycemia or low blood sugar||Fever|
|Yellow skin or eyes|
Some side effects are easily manageable and usually won’t require medical attention. They may go away on their own as the body adjusts to the medication. However, if you experience any unusual side effects or discomfort that persists during the course of your treatment, it’s best to consult with your healthcare provider.
Even though semaglutide is indicated for type 2 diabetes and weight loss management, not everyone may be eligible for the medication. Healthcare practitioners and doctors may prescribe oral or subcutaneous semaglutide to obese patients with a body mass index of more than 30 with at least 1 medical problem like high blood pressure, elevated cholesterol, or diabetes mellitus. Overweight individuals with a BMI of greater than 27 may also take this treatment.
However, your doctor may recommend other forms of anti-obesity and anti-diabetes drugs if you have a history of certain medical problems that may interfere with the medication’s effects. Here are some of the conditions that may hinder you from taking GLP 1 receptor agonist drugs:
Pregnant or breastfeeding women should also advise their doctor about their condition before taking oral or subcutaneous semaglutide. It's also important to mention other medications that you're currently taking to check if there are any interactions that may occur.
Your doctor will likely give you a set of instructions to follow once you start taking semaglutide for diabetes or weight loss management. It’s important to take note of these reminders to make sure that you're getting the desired effects from the medication. Here are some of the best practices when taking semaglutide:
Semaglutide is a novel treatment for type 2 diabetes and weight loss management. Due to its mechanism of action, the medication has also shown a positive CV benefit. This therapy may be helpful in lowering your overall risk for CV death and supporting your heart function while improving glycemic control and promoting weight loss.
Dr. V Medical Aesthetics is one of the leading centers that provide customized treatments for beauty and wellness in Florida. We offer comprehensive weight management plans with semaglutide to help you achieve your health goals and enhance your quality of life. Call us today to book a consultation with one of our doctors or to know more about our semaglutide treatments.
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