Oral Semaglutide in Routine Clinical Practice: 24-Month Real-World Effectiveness, Persistence and Safety in Adults With Type 2 Diabetes

Baldassarre and colleagues assessed oral semaglutide in routine care over 24 months in 232 adults with type 2 diabetes. Mean HbA1c fell by 0.8 percentage points and weight by 5.7 kg. Forty-four percent reached the combined target of HbA1c at or below 7% and at least 5% weight loss. Treatment persistence at 24 months was 68.5%. Kidney measures remained stable, while LDL and total cholesterol decreased. The report found no new safety concern in the observed cohort. These results describe practical effectiveness and persistence, not lifespan extension. The study is observational and lacks the randomised comparator needed to separate treatment effects from adherence, clinical selection, background care and regression to the mean. The population had type 2 diabetes, so the findings do not transfer directly to healthy adults using semaglutide for prevention. The study is relevant to metabolic health and the debate about geroprotective drug candidates, but it does not support an evidence-grade change for semaglutide or a claim that weight loss equals slower aging.

Oral semaglutide was effective and generally well tolerated over 24 months in routine clinical practice, with meaningful improvements in glycaemic control and body weight.