Real-world use of oral semaglutide may provide insight into glycemic and weight outcomes in individuals with type 2 diabetes mellitus (T2DM). A retrospective multicenter cohort analysis published in Diabetes, Obesity and Metabolism evaluated clinical outcomes associated with oral semaglutide use in routine care among patients with T2DM in Thailand.

The REALISED study included 195 adults with T2DM who initiated oral semaglutide between April 2022 and December 2023. Eligible individuals had no prior injectable therapy and completed at least 26 weeks of treatment. The primary endpoint was the change in glycated hemoglobin (HbA1c) from baseline to Week 26, with Week 52 outcomes assessed exploratorily. Secondary endpoints included change in body weight and the proportion achieving HbA1c <7%. A composite endpoint assessed HbA1c <7% with ≥3% weight loss.

Oral semaglutide was used predominantly as add-on therapy (190/195; 97.4%). At Week 26, mean HbA1c decreased by −0.7% (95% CI −0.9 to −0.5; p < 0.0001), and mean body weight decreased by −4.3 kg (95% CI −5.5 to −3.2; p < 0.0001). A total of 75.9% (117/154) achieved HbA1c <7%, and 57.7% (71/123) met the composite endpoint.

Dose escalation from 3 mg to 14 mg occurred in 53.2% of patients by Week 26 and 70.4% by Week 52. No severe hypoglycemia was reported during the study period. These findings show reductions in HbA1c and body weight with oral semaglutide use in routine clinical practice in this population.