Oral semaglutide improves body composition and preserves lean mass in patients with type 2 diabetes: a 26-week prospective real-life study
Open accessAbstract
Background: Oral semaglutide is the first glucagon-like peptide-1 receptor agonist (GLP-1RA) designed for oral administration; it offers a promising opportunity to facilitate an early approach to Type 2 Diabetes (T2D). The study aimed to evaluate, in a real-life setting, the effects of oral semaglutide on the body composition of patients with T2D after 26 weeks of therapy. Methods: Thirty-two patients with T2D were evaluated at baseline (T0) and after three (T3) and six (T6) months of therapy with oral semaglutide. At each time point, body composition was assessed using a phase sensitive bioimpedance analyzer. Clinical, anthropometric and laboratory parameters, and the main biometric surrogates of liver steatosis and fibrosis, were also analyzed and compared. Results: A significant and early reduction in anthropometric and glucometabolic parameters, alanine aminotransferase, Fatty Liver Index, and Fat Mass was observed. Visceral Adipose Tissue (VAT) decreased, while Fat Free Mass and Skeletal Muscle Mass (SMM) were preserved during therapy, resulting in a beneficial increase in the SMM/VAT ratio. Finally, an overall improvement in body fluid distribution was observed. Conclusion: Our real-world data confirm the clinical efficacy of oral semaglutide and highlight its ability to improve the nutritional status of patients with T2D.
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Observational real-world data in patients with type 2 diabetes receiving oral semaglutide for 26 weeks demonstrated preservation of fat-free and skeletal muscle mass despite significant losses in fat mass and visceral adipose tissue, suggesting that the magnitude of lean tissue change may depend on concomitant lifestyle behaviors such as physical activity and diet.
“Observational real-world data in patients with T2D receiving oral semaglutide for 26 weeks demonstrated preservation of fat-free and skeletal muscle mass despite significant losses in fat mass and visceral adipose tissue, suggesting that the magnitude of lean tissue change may depend on concomitant lifestyle behaviors, such as physical activity and diet [16].”
From Muscle loss and GLP-1R agonists use (2025) · cites this paper as [16]
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Self-citation
- Authors
- Volpe, S., Lisco, G., Fanelli, M., Racaniello, D., Colaianni, V., Lavarra, V., Triggiani, D., Crudele, L., Triggiani, V., Sabbà, C., De Pergola, G., & Piazzolla, G.
- Affiliations
- University of Bari Aldo Moro (IT)
- Corresponding author
- Fanelli, Margherita
- Piazzolla, Giuseppina
- ORCID
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2023-09-13
- Volume
- 14
- Pages
- 1240263-1240263
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC10534984
- OpenAlex
- W4386697952
- Cited by
- 73
- References
- 56
- Citations by year
- 2026: 23 · 2025: 25 · 2024: 24 · 2023: 1
- FWCI
- 14.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- oral semaglutide, type 2 diabetes, body composition, lean mass preservation, skeletal muscle mass, visceral adipose tissue, fat mass, hepatic steatosis, liver fibrosis, GLP-1 receptor agonists, bioimpedance, real-world effectiveness, nutritional status
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Semaglutide, Body Composition, Diabetes Mellitus, Type 2, Gastrointestinal Agents, Humans, Hypoglycemic Agents, Prospective Studies
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