1
|
Ding B, Zhu Z, Guo C, Li J, Gan Y, Yu M. Oral peptide therapeutics for diabetes treatment: State-of-the-art and future perspectives. Acta Pharm Sin B 2024; 14:2006-2025. [PMID: 38799624 PMCID: PMC11120284 DOI: 10.1016/j.apsb.2024.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/04/2023] [Accepted: 12/26/2023] [Indexed: 05/29/2024] Open
Abstract
Diabetes, characterized by hyperglycemia, is a major cause of death and disability worldwide. Peptides, such as insulin and glucagon-like peptide-1 (GLP-1) analogs, have shown promise as treatments for diabetes due to their ability to mimic or enhance insulin's actions in the body. Compared to subcutaneous injection, oral administration of anti-diabetic peptides is a preferred approach. However, biological barriers significantly reduce the efficacy of oral peptide therapeutics. Recent advancements in drug delivery systems and formulation techniques have greatly improved the oral delivery of peptide therapeutics and their efficacy in treating diabetes. This review will highlight (1) the benefits of oral anti-diabetic peptide therapeutics; (2) the biological barriers for oral peptide delivery, including pH and enzyme degradation, intestinal mucosa barrier, and biodistribution barrier; (3) the delivery platforms to overcome these biological barriers. Additionally, the review will discuss the prospects in this field. The information provided in this review will serve as a valuable guide for future developments in oral anti-diabetic peptide therapeutics.
Collapse
Affiliation(s)
- Bingwen Ding
- State Key Laboratory of Drug Research and Center of Pharmaceutics, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhu Zhu
- State Key Laboratory of Drug Research and Center of Pharmaceutics, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- School of Pharmacy, Henan University, Kaifeng 475004, China
| | - Cong Guo
- State Key Laboratory of Drug Research and Center of Pharmaceutics, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jiaxin Li
- State Key Laboratory of Drug Research and Center of Pharmaceutics, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yong Gan
- State Key Laboratory of Drug Research and Center of Pharmaceutics, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- University of Chinese Academy of Sciences, Beijing 100049, China
- NMPA Key Laboratory for Quality Research and Evaluation of Pharmaceutical Excipients, National Institutes for Food and Drug Control, Beijing 100050, China
| | - Miaorong Yu
- State Key Laboratory of Drug Research and Center of Pharmaceutics, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| |
Collapse
|
2
|
Wu J, Jones N, Hohenwarter L, Zhao F, Chan V, Tan Z, Carlaw T, Morin T, Li J, Kaur T, Andrew LJ, Ross CJD, Hedtrich S, Li SD. Systemic delivery of proteins using novel peptides via the sublingual route. J Control Release 2024; 368:290-302. [PMID: 38423473 DOI: 10.1016/j.jconrel.2024.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
Therapeutic proteins often require needle-based injections, which compromise medication adherence especially for those with chronic diseases. Sublingual administration provides a simple and non-invasive alternative. Herein, two novel peptides (lipid-conjugated protamine and a protamine dimer) were synthesized to enable sublingual delivery of proteins through simple physical mixing with the payloads. It was found that the novel peptides promoted intracellular delivery of proteins via increased pore formation on the cell surface. Results from in vitro models of cell spheroids and human sublingual tissue substitute indicated that the novel peptides enhanced protein penetration through multiple cell layers compared to protamine. The novel peptides were mixed with insulin or semaglutide and sublingually delivered to mice for blood glucose (BG) control. The effects of these sublingual formulations were comparable to the subcutaneous preparations and superior to protamine. In addition to peptide drugs, the novel peptides were shown to enable sublingual absorption of larger proteins with molecular weights from 22 to 150 kDa in mice, including human recombinant growth hormone (rhGH), bovine serum albumin (BSA) and Immunoglobulin G (IgG). The novel peptides given sublingually did not induce any measurable toxicities in mice.
Collapse
Affiliation(s)
- Jiamin Wu
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Natalie Jones
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Lukas Hohenwarter
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Feng Zhao
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Vanessa Chan
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Zheng Tan
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Tiffany Carlaw
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Tessa Morin
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Jing Li
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Tejinder Kaur
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Lucas J Andrew
- Department of Chemistry, University of British Columbia, Vancouver, British Columbia, V6T 1Z1, Canada
| | - Colin J D Ross
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Sarah Hedtrich
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Shyh-Dar Li
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada..
| |
Collapse
|
3
|
Pinto S, Hosseini M, Buckley ST, Yin W, Garousi J, Gräslund T, van Ijzendoorn S, Santos HA, Sarmento B. Nanoparticles targeting the intestinal Fc receptor enhance intestinal cellular trafficking of semaglutide. J Control Release 2024; 366:621-636. [PMID: 38215986 DOI: 10.1016/j.jconrel.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024]
Abstract
Semaglutide is the first oral glucagon-like peptide-1 (GLP-1) analog commercially available for the treatment of type 2 diabetes. In this work, semaglutide was incorporated into poly(lactic-co-glycolic acid)-poly(ethylene glycol) (PLGA-PEG) nanoparticles (NPs) to improve its delivery across the intestinal barrier. The nanocarriers were surface-decorated with either a peptide or an affibody that target the human neonatal Fc receptor (hFcRn), located on the luminal cell surface of the enterocytes. Both ligands were successfully conjugated with the PLGA-PEG via maleimide-thiol chemistry and thereafter, the functionalized polymers were used to produce semaglutide-loaded NPs. Monodisperse NPs with an average size of 170 nm, neutral surface charge and 3% of semaglutide loading were obtained. Both FcRn-targeted NPs exhibited improved interaction and association with Caco-2 cells (cells that endogenously express the hFcRn), compared to non-targeted NPs. Additionally, the uptake of FcRn-targeted NPs was also observed to occur in human intestinal organoids (HIOs) expressing hFcRn through microinjection into the lumen of HIOs, resulting in potential increase of semaglutide permeability for both ligand-functionalized nanocarriers. Herein, our study demonstrates valuable data and insights that the FcRn-targeted NPs has the capacity to promote intestinal absorption of therapeutic peptides.
Collapse
Affiliation(s)
- Soraia Pinto
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Mahya Hosseini
- Department of Biomedical Sciences of Cell and Systems, Section Molecular Cell Biology, University Medical Center Groningen, University of Groningen, 9713, AV, Groningen, the Netherlands
| | - Stephen T Buckley
- Global Research Technologies, Novo Nordisk, Novo Nordisk Park 1, 2760 Måløv, Denmark
| | - Wen Yin
- Department of Protein Science, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Roslagstullsbacken 21, 114 17 Stockholm, Sweden
| | - Javad Garousi
- Department of Protein Science, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Roslagstullsbacken 21, 114 17 Stockholm, Sweden; Department of Immunology, Genetics and Pathology, Uppsala University, 75185 Uppsala, Sweden
| | - Torbjörn Gräslund
- Department of Protein Science, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Roslagstullsbacken 21, 114 17 Stockholm, Sweden
| | - Sven van Ijzendoorn
- Department of Biomedical Sciences of Cell and Systems, Section Molecular Cell Biology, University Medical Center Groningen, University of Groningen, 9713, AV, Groningen, the Netherlands
| | - Hélder A Santos
- Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5E, Helsinki FI-00014, Finland; W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, the Netherlands; Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, the Netherlands.
| | - Bruno Sarmento
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal; Instituto Universitário de Ciências da Saúde (IUCS-CESPU), Rua Central de Gandra 1317, 4585-116 Gandra, Portugal.
| |
Collapse
|
4
|
Solis-Herrera C, Kane MP, Triplitt C. Current Understanding of Sodium N-(8-[2-Hydroxylbenzoyl] Amino) Caprylate (SNAC) as an Absorption Enhancer: The Oral Semaglutide Experience. Clin Diabetes 2023; 42:74-86. [PMID: 38230324 PMCID: PMC10788673 DOI: 10.2337/cd22-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Oral administration of peptide therapeutics faces challenges because of the distinct environment of the gastrointestinal tract. An oral formulation of semaglutide, a glucagon-like peptide 1 receptor agonist, was approved by the U.S. Food and Drug Administration in 2019 as a peptide therapy for the treatment of type 2 diabetes. Oral semaglutide uses sodium N-(8-[2-hydroxybenzoyl] amino) caprylate (SNAC) technology to enhance the absorption of semaglutide in the stomach and protect it from degradation by gastric enzymes. This article presents a summary of studies investigating SNAC technology as an absorption enhancer for a number of molecules and, in particular, explores how SNAC, once coformulated with oral semaglutide, facilitates increased absorption and bioavailability. Practical advice and dispensing information for pharmacists is also provided.
Collapse
Affiliation(s)
- Carolina Solis-Herrera
- Division of Diabetes, University of Texas Health Science Center, San Antonio, TX
- Division of Endocrinology, University of Texas Health Science Center, San Antonio, TX
| | - Michael P. Kane
- Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY
| | - Curtis Triplitt
- Division of Diabetes, University of Texas Health Science Center, San Antonio, TX
| |
Collapse
|
5
|
Cabral Lopes A, Roque F, Lourenço O, Herdeiro MT, Morgado M. Gastrointestinal disorders potentially associated with Semaglutide: an analysis from the Eudravigilance Database. Expert Opin Drug Saf 2023; 22:455-461. [PMID: 36695099 DOI: 10.1080/14740338.2023.2172159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/09/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Semaglutide is a Glucagon-like peptide-1 receptor agonist used in the second-line treatment of poorly controlled type 2 diabetes and can be used in monotherapy or associated with other oral antidiabetics or even insulin, increasing the effectiveness of the treatment. This work aims to analyze the profile of adverse drug reactions reported for semaglutide in Eudravigilance. RESEARCH DESIGN AND METHODS Data on Individual Cases Safety Reports were obtained from the database of the centralized European spontaneous reporting system Eudravigilance by accessing www.adrreports.eu. (1 December 2021). RESULTS It is possible to observe a high prevalence of gastrointestinal disorders (N = 3502, 53.2%). The most severe reported cases were primarily gastrointestinal disorders, metabolic, and nutritional disorders, eye disorders, renal and urinary disorders and cardiac disorders, with an evident higher prevalence of adverse gastrointestinal events both in oral and injectable dosage form (N = 133, 50.0% vs N = 588, 47.2%, respectively). Through a comparative analysis, semaglutide had a greater number of reported gastrointestinal adverse events compared to sitagliptin and empaglifozin (p < 0.00001). CONCLUSIONS Semaglutide has a good safety profile, however the definition of subgroups within the type 2 diabetes population who are particularly prone to develop serious adverse event when treated with GLP-1 RAs is crucial.
Collapse
Affiliation(s)
- António Cabral Lopes
- Pharmaceutical Services of Unity Local of Health of Guarda (ULS da Guarda), Guarda, Portugal
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), Covilhã, Portugal
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Covilhã, Portugal
| | - Olga Lourenço
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), Covilhã, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Covilhã, Portugal
| | - Maria Teresa Herdeiro
- Institute of Biomedicine, Department of Medical Sciences (iBiMED-UA), University of Aveiro, Portugal
| | - Manuel Morgado
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), Covilhã, Portugal
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Covilhã, Portugal
- Pharmaceutical Services of University Hospital Center of Cova da Beira, Covilhã, Portugal
| |
Collapse
|
6
|
Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, Castro A, Cebrián-Cuenca A, de Torres-Sánchez A, García-de-Lucas MD, Núñez J, Obaya JC, Soler MJ, Górriz JL, Rubio-Herrera MÁ. Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. J Clin Med 2022; 12:jcm12010145. [PMID: 36614945 PMCID: PMC9821052 DOI: 10.3390/jcm12010145] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are indicated in type 2 diabetes and obesity for their high efficacy in controlling glycaemia and inducing body weight loss, respectively. Patients may develop gastrointestinal adverse events (GI AEs), namely nausea, vomiting, diarrhoea and/or constipation. To minimize their severity and duration, healthcare providers (HCPs) and patients must be aware of appropriate measures to follow while undergoing treatment. An expert panel comprising endocrinologists, nephrologists, primary care physicians, cardiologists, internists and diabetes nurse educators convened across virtual meetings to reach a consensus regarding these compelling recommendations. Firstly, specific guidelines are provided about how to reach the maintenance dose and how to proceed if GI AEs develop during dose-escalation. Secondly, specific directions are set about how to avoid/minimize nausea, vomiting, diarrhoea and constipation symptoms. Clinical scenarios representing common situations in daily practice, and infographics useful to guide both HCPs and patients, are included. These recommendations may prevent people with T2D and/or obesity from withdrawing from GLP-1 RAs treatment, thus benefitting from their superior effect on glycaemic control and weight loss.
Collapse
Affiliation(s)
- Juan J. Gorgojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain
| | - Pedro Mezquita-Raya
- Department of Endocrinology and Nutrition, Hospital Universitario Torrecárdenas, 04009 Almería, Spain
| | - Juana Carretero-Gómez
- Department of Internal Medicine, University Hospital of Badajoz, 06080 Badajoz, Spain
| | - Almudena Castro
- Department of Cardiology, University Hospital la Paz, IdiPAZ, Biomedical Research Center-Cardiovascular Diseases (CIBERCV-ISCIII), 28046 Madrid, Spain
| | - Ana Cebrián-Cuenca
- Health Centre Casco Antiguo Cartagena, Primary Care Research Group, Biomedical Research Institute of Murcia (IMIB), 30201 Cartagena, Spain
| | | | | | - Julio Núñez
- Department of Cardiology, Valencia Clinic University Hospital, Instituto de Investigación Sanitaria (INCLIVA), 46010 Valencia, Spain
| | | | - María José Soler
- Nephrology and Kidney Transplantation Research Group, Nephrology Department, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, 08035 Barcelona, Spain
| | - José Luis Górriz
- Nephrology Department, Valencia Clinic University Hospital, Instituto de Investigación Sanitaria (INCLIVA), Universitat de València, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-961973811; Fax: +34-961970977
| | - Miguel Ángel Rubio-Herrera
- Department of Endocrinology and Nutrition, San Carlos Clinical Hospital, Health Research Institute of the San Carlos Clinical Hospital (IDISSC), 28040 Madrid, Spain
| |
Collapse
|
7
|
Demidowich AP, Batty K, Zilbermint M. Instituting a Successful Discharge Plan for Patients With Type 2 Diabetes: Challenges and Solutions. Diabetes Spectr 2022; 35:440-451. [PMID: 36561646 PMCID: PMC9668725 DOI: 10.2337/dsi22-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Achieving target inpatient glycemic management outcomes has been shown to influence important clinical outcomes such as hospital length of stay and readmission rates. However, arguably the most profound, lasting impact of inpatient diabetes management is achieved at the time of discharge-namely reconciling and prescribing the right medications and making referrals for follow-up. Discharge planning offers a unique opportunity to break through therapeutic inertia, offer diabetes self-management education, and institute an individualized treatment plan that prepares the patient for discharge and promotes self-care and engagement. However, the path to a successful discharge plan can be fraught with potential pitfalls for clinicians, including lack of knowledge and experience with newer diabetes medications, costs, concerns over insurance coverage, and lack of time and resources. This article presents an algorithm to assist clinicians in selecting discharge regimens that maximize benefits and reduce barriers to self-care for patients and a framework for creating an interdisciplinary hospital diabetes discharge program.
Collapse
Affiliation(s)
- Andrew P. Demidowich
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Community Physicians at Howard County General Hospital, Division of Hospital Medicine, Johns Hopkins Medicine, Columbia, MD
| | - Kristine Batty
- Johns Hopkins Community Physicians at Howard County General Hospital, Division of Hospital Medicine, Johns Hopkins Medicine, Columbia, MD
| | - Mihail Zilbermint
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Community Physicians at Suburban Hospital, Division of Hospital Medicine, Johns Hopkins Medicine, Bethesda, MD
| |
Collapse
|
8
|
Rajput R, Ghosh S, Banerjee S, Bansal B, Chawla M, Ahluwalia AI, Lathia T, Das AK. First-in-Class Oral Semaglutide: Overcoming Barriers of Incretinisation in the Indian Context. Indian J Endocrinol Metab 2022; 26:417-427. [PMID: 36618518 PMCID: PMC9815186 DOI: 10.4103/ijem.ijem_217_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022] Open
Abstract
Despite the availability of multiple therapeutic options and strategies, patients with type 2 diabetes mellitus (T2DM) the world over have inadequate glycaemic control and India is no exception. Patients with T2DM in India have benefitted from glucagon-like peptide-1 analogues similar to that of patients from other parts of the world. However, subcutaneous treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is limited by their injectable mode of administration. The present review highlights barriers to incretinisation with GLP-1RAs and the role of first-in-class oral semaglutide in the Indian context and provides guidance to physicians on its initiation and uses.
Collapse
Affiliation(s)
- Rajesh Rajput
- Department of Endocrinology, PGIMS, Rohtak, Haryana, India
| | - Sujoy Ghosh
- Department of Endocrinology, IPGME&R, Kolkata, West Bengal, India
| | - Samar Banerjee
- Department of Medicine, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Beena Bansal
- Consultant, Department of Endocrinologist, Door-To-Care, An Endocrine and Diabetes Clinic, Gurugram, Haryana, India
| | - Manoj Chawla
- MBBS, Diabetologist, FRSSDI, FRCP (Edin), Director and Consultant Diabetologist, Lina Diabetes Care Centre, Mumbai, Maharashtra, India
| | - Abhay I. Ahluwalia
- Senior Consultant, Department of Endocrinologist Manipal Hospital, Gurgaon, Haryana, India
| | - Tejal Lathia
- Consultant, Department of Endocrinologist, Fortis, Apollo and Cloud Nine Hospitals, Navi Mumbai, Maharashtra, India
| | - Ashok K. Das
- Consultant, Department of Endocrinologist, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
| |
Collapse
|
9
|
Kalra S, Kapoor N. Oral Semaglutide: Dosage in Special Situations. Diabetes Ther 2022; 13:1133-1137. [PMID: 35532859 PMCID: PMC9174361 DOI: 10.1007/s13300-022-01265-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
Glucagon-like peptide 1 receptor agonists (GLP1RAs) have recently gained momentum after the introduction of semaglutide, the first oral molecule in their class. In a recent article in this journal by Evans et al., a succinct overview of the utility of semaglutide is highlighted in the context of virtual diabetes care. To take this discussion further, this commentary describes the value and positioning of oral semaglutide in common clinical situations. Its insights assist in pragmatic placement of this drug in clinical practice. Special emphasis is laid on the use of oral semaglutide in persons already on injectable GLP-1RA formulations, those experiencing sudden changes in life style pattern due to religious, social, or professional commitments, individuals seeking help for urgent glycemic control, and those who face sudden change in their concomitant medications or comorbidities.
Collapse
Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, 132001, India.
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| |
Collapse
|
10
|
Horowitz M, Rayner CK, Marathe CS, Wu T, Umapathysivam M, Jones KL. Response to Dahl et al.: Oral semaglutide improves postprandial glucose and lipid metabolism, and delays gastric emptying, in subjects with type 2 diabetes. Diabetes Obes Metab 2021; 23:2411-2413. [PMID: 34169640 DOI: 10.1111/dom.14473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Michael Horowitz
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Christopher K Rayner
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Chinmay S Marathe
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Tongzhi Wu
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Mahesh Umapathysivam
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Karen L Jones
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| |
Collapse
|