New Side Effects of Semaglutide
About
Medications such as semaglutide and other Glucagon-like Peptide-1 receptor agonists (GLP-1 agonists) represent a beacon of hope not just for overweight diabetic patients, but also for those who are generally overweight or obese. The demand for pharmaceutical weight-loss drugs has surged alongside the growing obesity crisis, marking a significant trend in recent years.
Estimates from World Health Organization indicates that over 750 million people are living with obesity and the global market for anti-obesity medications in 2023 reached $6 billion. It is estimated that by 2030, it could grow by more than 16 times to $100 billion, according to Goldman Sachs Research.
What is Semaglutide?
The US Food and Drug Administration approved the drug semaglutide in June 2021 under the brand names Wegovy for chronic weight management and Ozempic for type 2 diabetes mellitus. As Ozempic is intended for type 2 diabetes mellitus, it is prescribed off-label for weight loss(1✔).
Semaglutide, stimulates the body to produce more insulin and hence reduces blood glucose. In pancreas there is another hormone secreted called glucagon that kicks into action when the glucose level falls. Glucagon pushes the level up to maintain the balance. Semaglutide is a Glucagon-like Peptide-1 receptor agonists (GLP-1 agonists), and has become a commonly prescribed drug for weight-loss.
Glucagon-like peptide-1 receptor agonists are similar to the GLP-1 hormone, which is secreted in the gastrointestinal tract in response to eating.
How Does Semaglutide Reduces Weight?
Semaglutide increases incretin function by activating GLP-1 receptors. It works by stimulating insulin secretion after a meal, reducing glucagon secretion, delaying gastric emptying, causing a reduction in hunger and food intake, slowing the release of food from the stomach, and increasing feelings of fullness after eating(2✔).
Over a period of time semaglutide has shown improvement in cardiac and kidney function. It also helps with glycemic control by lowering body weight, which is important for patients with type 2 diabetes
Side Effects of Semaglutide
Semaglutide has several advantages, it is not without side-effects.
Nausea, vomiting, and diarrhea are some of the most commonly reported side effects.
New Side Effects of Semaglutide
The American Society of Anesthesiologists issued new warning in June to stop taking GLP-1 agonists before elective surgery because they can cause vomiting in patients under anesthesia.
Later, in October, a research letter published in JAMA indicated serious gastrointestinal problems in some obese patients treated with GLP-1 agonists.
"When treating millions of people with medications like semaglutide, even relatively rare side effects will occur in a large number of people," said Susan Yanovski, MD, senior scientific advisor for clinical obesity research and codirector of the National Institute of Diabetes and Digestive and Kidney Diseases' Office of Obesity Research(3✔).
The society also warned that if GLP-1 is taken on the day of surgery or before a week of surgery may slow gastric motility and delay the restoration of proper gastrointestinal function during the recovery(4✔).
More Gastrointestinal Adverse Events
Researchers in Canada conducted a study to compare the safety outcomes of GLP-1 like Semaglutide. They have compared the GLP-1 agonist to bupropion-naltrexone, an older class of weight-loss medication. This was a retrospective study that included 4,144 people with obesity who were prescribed liraglutide, 613 prescribed semaglutide, and 654 prescribed the older treatment. People with diabetes were excluded from the study(3✔).
The study concluded GLP-1 has an increased risk of -
- Pancreatitis
- Bowel obstruction
- Gastroparesis causing stomach paralysis.
Acute pancreatitis and gall bladder disease are well-known side effects of semaglutide and are listed on the labels of all formulations. However, gastroparesis and bowel obstruction were new adverse reactions concluded by the study.
Gastroparesis is a disorder in which the contractions of the stomach muscles weaken, making digestion and the passage of food to the intestines difficult. This condition is unlikely to be present in those recently diagnosed with diabetes or those taking the drug for weight loss(5✔).
Other Long-term Risk of GLP-1
Studies on mice suggest that there may be a risk of medullary thyroid cancer, but as cancer is a latent disease, it will take many years to collect data on humans.
Prevention of Adverse Reaction
- Starting with a lower dose and going slow is the only way to prevent adverse reactions.
- To avoid anesthetic complications, patients may be advised to discontinue semaglutide or GLP agonists a week before surgery, or they may need to have an ultrasound to check the contents of their stomach before anesthesia is administered.
- While taking this medication, if a patient happens to have persistent vomiting, that should seek help from the physician.
- Once the medication is stopped, it will resolve all the side effects.
Conclusion
Semaglutide is widely used for type 2 diabetes mellitus; it is also used off-label for weight management. As their popularity soars, rare and serious side effects are emerging. Semaglutide has shown benefits for many people with obesity, particularly those with more severe obesity who have related complications. The benefits of these medications are quite likely to outweigh the risks.
References:
- New Horizons. A New Paradigm for Treating to Target with Second-Generation Obesity Medications.�- (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947217/)
- Weight Loss and Maintenance Related to the Mechanism of Action of Glucagon-Like Peptide-1 Receptor Agonists - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189979/)
- As Semaglutide's Popularity Soars, Rare but Serious Adverse Effects Are Emerging - (https://jamanetwork.com/journals/jama/fullarticle/2812192#)
- Anesthesia Considerations for a Patient on Semaglutide and Delayed Gastric Emptying - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438952/#)
- Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. - (https://pubmed.ncbi.nlm.nih.gov/37796527/)
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Dr. M. Sree Mohana Preetha. (2023, December 13). New Side Effects of Semaglutide. Medindia. Retrieved on Dec 24, 2024 from https://www.medindia.net/health/conditions/new-side-effects-of-semaglutide.htm.
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Dr. M. Sree Mohana Preetha. "New Side Effects of Semaglutide". Medindia. Dec 24, 2024. <https://www.medindia.net/health/conditions/new-side-effects-of-semaglutide.htm>.
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Dr. M. Sree Mohana Preetha. "New Side Effects of Semaglutide". Medindia. https://www.medindia.net/health/conditions/new-side-effects-of-semaglutide.htm. (accessed Dec 24, 2024).
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Dr. M. Sree Mohana Preetha. 2023. New Side Effects of Semaglutide. Medindia, viewed Dec 24, 2024, https://www.medindia.net/health/conditions/new-side-effects-of-semaglutide.htm.