Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42% < 5 years), and a minority (15.6%) had a history of cardiovascular events. Importantly, oral semaglutide was started in subjects with various disease durations and background therapies. Notably, its initiation was accompanied by de-prescription of sulfonylureas, pioglitazone, DPP-4 inhibitors, and insulin. Choice of oral semaglutide was influenced by patient profiles and ongoing glucose-lowering regimens. Factors such as younger age, higher HbA1c, and ongoing SGLT-2 inhibitor therapy drove the choice of oral semaglutide with the aim of improving glycemic control. Projected glycemic effectiveness analysis revealed that oral semaglutide could potentially lead HbA1c to target in > 60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management.

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Prodam, Flavia
Membro del Collaboration Group
;
Tassone, Francesco
Membro del Collaboration Group
;
Allasia, Stefano
Membro del Collaboration Group
;
Balbo, Marcella
Membro del Collaboration Group
;
Beccuti, Guglielmo
Membro del Collaboration Group
;
Bonelli, Nadia
Membro del Collaboration Group
;
Cambria, Valeria
Membro del Collaboration Group
;
Caputo, Marina
Membro del Collaboration Group
;
Garino, Francesca
Membro del Collaboration Group
;
Marinazzo, Elisa
Membro del Collaboration Group
;
Me, Elisa
Membro del Collaboration Group
;
Poli, Roberta
Membro del Collaboration Group
;
2023-01-01

Abstract

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42% < 5 years), and a minority (15.6%) had a history of cardiovascular events. Importantly, oral semaglutide was started in subjects with various disease durations and background therapies. Notably, its initiation was accompanied by de-prescription of sulfonylureas, pioglitazone, DPP-4 inhibitors, and insulin. Choice of oral semaglutide was influenced by patient profiles and ongoing glucose-lowering regimens. Factors such as younger age, higher HbA1c, and ongoing SGLT-2 inhibitor therapy drove the choice of oral semaglutide with the aim of improving glycemic control. Projected glycemic effectiveness analysis revealed that oral semaglutide could potentially lead HbA1c to target in > 60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management.
2023
14
12
2159
2172
Cardiovascular risk; GLP-1; Management; Survey; Therapeutic inertia; Type 2 diabetes
Morieri, Mario Luca; Candido, Riccardo; Frontoni, Simona; Disoteo, Olga; Solini, Anna; Fadini, Gian Paolo; Bellanti, Francesco; Caprio, Massimiliano; Cutolo, Michele; Formoso, Gloria; Forte, Elisa; Frison, Vera; Gregori, Giovanna; Lencioni, Cristina; Leto, Gaetano; Mandica, Salvatore; Marangoni, Alberto; Memoli, Pasqualina; Memoli, Giuseppe; Negri, Carlo; Nollino, Laura; Perrelli, Andrea; Perrini, Sebastio; Prodam, Flavia; Rebora, Alberto; Sansone, Daniela; Sciaraffia, Marcello; Settembrini, Silvio; Sodo, Gaetano; Tassone, Francesco; Todisco, Valentina; Vetrano, Antonio; Accardo, Giacomo; Albanese, Valeria; Alemanno, Irene; Allasia, Stefano; Alosa, Rosario; Altomari, Anna; Amato, Anna Maria Letizia; Ambrosetti, Eleonora; Angarano, Angela; Angotti, Stefania; Anichini, Roberto; Baccetti, Fabio; Balbo, Marcella; Balestra, Elisabetta; Balzano, Sara; Barone, Maria; Baronti, Walter; Basso, Veronica; Beccuti, Guglielmo; Bellone, Iaele Maria; Bertolotto, Alessandra; Bettio, Michela; Bittante, Cristina; Bonelli, Nadia; Bongiovanni, Marzia; Bonora, Benedetta Maria; Bonsembiante, Barbara; Borgognoni, Laura; Bracaglia, Daniela; Braione, Antonia Francesca; Brancario, Clementina; Braucci, Sabrina; Briatore, Lucia; Brun, Elisabetta; Cambria, Valeria; Cantino, Elena; Capitanata, Paolo; Cappello, Sergio; Caputo, Marina; Carabba, Barbara; Carpenito, Alberto; Castellana, Marco; Castrovilli, Anna; Cataldo, Donato; Cazzetta, Giuliana; Cecoli, Francesca; Chilelli, Nino Cristiano; Cianciullo, Marco; Coccia, Federica; Colarusso, Sara; Colella, Caterina; Colletti, Isabella; Coluzzi, Sara; Conte, Marisa; Corigliano, Marco; Cosma, Alessandra; Costa, Silvana; Daniele, Pantaleo; D’aurizio, Maria; De Bellis, Alessandra; De Candia, Lorenzo; De Gennaro, Giovanni; De Luca, Ezechiele; De Natale, Claudia; De Simone, Giuseppina; De Simone, Raffaele; Del Buono, Andrea; Delmonte, Vincenza; Devangelio, Eleonora; Biase, Nicolina; Di Giovanni, Giuseppe; Di Palo, Mariarosaria; Divella, Caterina; Dolcino, Mara; Egione, Oreste; Farese, Anna; Fatone, Saverio; Filippi, Alessio; Fiore, Daniela; Fiorentini, Paolo; Fiori, Rossana; Fittipaldi, Maria Rosa; Floriddia, Giuseppina; Franco, Luca; Fusco, Alessandra; Galdieri, Sergio; Gallo, Alessandra; Gardini, Maria Alessandra; Garino, Francesca; Gatti, Adriano; Gatto, Valentina; Gauna, Carlotta; Gesuè, Luigi; Giacchini, Anna; Giannettino, Raffeale; Giannini, Debora; Gioia, Filomena; Giuffrida, Domenica; Goglia, Umberto; Golia, Francesco; Gottardo, Lucia; Gramaglia, Elena; Grasso, Marco; Graziuso, Massimo; Gualdiero, Roberto; Guarnieri, Rita Graziella; Iazzetta, Nicolangelo; Infante, Marco; Innelli, Francesca; Iovino, Angelantonio; Izzo, Giovanni; Lampitella, Antonio; Lanzilli, Antonio; Lapice, Emanuela; Lassandro, Anna Pia; Latina, Adele; Laudato, Mario; Pantano, Angelo Lauria; Leporati, Paola; Lo Conte, Filomena; Lucatello, Barbara Giovanna; Lucianer, Tiziano; Macerola, Barbara; Maggi, Valeria; Maggioli, Chiara; Maglione, Emilia; Manetti, Francesco; Manicone, Mariangela; Marcocci, Andrea; Mariano, Valentina; Marinazzo, Elisa; Mariniello, Anna Maria; Marrazzo, Giuseppe; Martedì, Emilia; Martini, Paolo; Masin, Michela; Me, Elisa; Menduni, Marika; Mesturino, Chiara Alberta; Mignano, Sabato; Milano, Nicola; Modugno, Monica; Monti, Eleonora; Mori, Mary; Nazzari, Elena; Nunziata, Giuseppe Pietro; Oliva, Domenica; Orio, Marcello; Palena, Antonio Pio; Paraggio, Pio; Pascale, Lisangela; Pascuzzo, Maria Divina; Peluso, Angela; Peragine, Dorotea; Petraroli, Ettore; Petraroli, Giuliana; Piccolo, Giovanni Paolo; Piscopo, Marco; Poli, Roberta; Potenziani, Stella; Quinto, Maria Chiara; Renzullo, Andrea; Rizzo, Gaetano Emanuele; Romano, Rossella; Rossi, Ernesto; Rubbo, Ilaria; Ruga, Gilda; Sabbatini, Angela; Santilli, Francesca; Saraceno, Giovanna; Savino, Patrizia; Scalabrì, Francesco; Scarano, Carla; Scioti, Maria Pia; Scotton, Rachele; Selleri, Antonello; Senesi, Antonella; Sidoti, Marilena; Sorrentino, Maria Rosaria; Strazzabosco, Marco; Strippoli, Daniela; Talco, Miryam; Tedeschi, Anna; Terracciano, Annamaria; Tirelli, Gilda; Tricò, Domenico; Turco, Salvatore; Turco, Anna Amelia; Valente, Livio; Vallone, Valeria; Vinci, Carmela; Wolosinska, Danuta Teresa; null, null
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