factors predicting glucose and weight response to injectable semaglutide (Ozempic): real-world data from the Association of British Clinical Diabetologists’ audit programme

Background: Previous randomised controlled trials have observed individual differences in response to Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) according to baseline characteristics such as glycated haemoglobin (HbA1c) and weight. The Association of British Clinical Diabetologists (ABCD) launched a nationwide UK audit in January 2019 to assess the clinical utility, efficacy and safety of injectable semaglutide in routine practice. The aim of this analysis was to investigate associations between baseline characteristics and HbA1c and weight reductions with semaglutide in real-world use. Methods: Data were extracted from the secure online tool and individuals who had baseline and follow-up data available within a defined 6 (3-9) month window were included. Variables were assessed as both continuous variables and categorical variables in a multivariate regression model. Missing data were multiply imputed. Results: In total, 620 individuals were included. Baseline characteristics: (mean±SD) age was 58.7±10.7 years, HbA1c 81.6±18.5 mmol/mol (9.5±1.7%), weight 108.2±24.2 kg and body mass index (BMI) 37.6±7.6 kg/m2. Median diabetes duration was 11.2 years (IQR 6.6-16) and 50.5% (313/620) of subjects were male. The median follow-up time was 0.5 years. HbA1c reduced by 14.9 mmol/mol (95% CI 13.5, 16.1) [-1.4% (95% CI - 1.2, -1.5)]; p<0.001; and weight reduced by 4.2kg (95% CI 3.6, 4.8; p<0.001). Higher HbA1c, younger age and GLP1RA naïvety were associated with larger HbA1c reduction. Higher baseline weight/BMI and GP1RA naïvety were associated with larger weight reduction. Conclusion: In this real-world study, baseline HbA1c and weightwere important predictors of HbA1c and weight reduction outcomes following initiation of semaglutide in routine clinical practice. Our data mirror existing randomised controlled trial data, but further evidence is being collected over a longer follow-up period.