Semaglutide binds to GLP-1 receptors and does 4 main things:

• • Stimulates glucose-dependent insulin secretion it boosts insulin release from pancreatic beta cells, but only when blood glucose is elevated, which keeps the hypoglycaemia risk relatively low compared to some other diabetes drugs.
  • Suppresses glucagon secretion it reduces the release of glucagon from pancreatic alpha cells, which lowers hepatic glucose output (less glucose gets dumped into the blood by the liver).
  • Slows gastric emptying. The stomach empties more slowly, dampening post-meal blood sugar spikes and contributing heavily to the early satiety/fullness people report.

• Acts on the brain to reduce appetite it crosses into areas of the hypothalamus and brainstem involved in appetite regulation, increasing feelings of satiety and reducing hunger and food cravings. This is the main driver of the weight loss effect.
• Glucose Control: It may release more insulin from pancreas only when blood sugar is high and the glucagon goes down.

Safety and Efficacy:

Efficacy

• Lowers HbA1c by roughly 1.5–2.0 percentage points depending on dose and formulation.
• Injectable form tends to outperform oral (Rybelsus) for glycemic control.
• Cardiovascular benefit: the SUSTAIN-6 trial showed a reduction in major adverse cardiovascular events (MACE) in patients with established cardiovascular disease or high risk.
• Average weight loss of ~15% of body weight over 68 weeks, notably higher than older weight-loss drugs.
• Also shown to reduce cardiovascular events in people with obesity/overweight and known heart disease, independent of diabetes status.
• Effects plateau over time and largely reverse if the drug is stopped, so it’s generally treated as a long-term/chronic therapy.

Safety

It may show some side effects that may can vary from individual to individual i.e., Nausea, vomiting, diarrhea, constipation, Abdominal pain, bloating, Decreased appetite, Fatigue, headache, Injection site reactions.

Precautions

• If you are with prior medical condition of Thyroid C Cell tumors, Pancreatitis, Gallbladder disease, diabetic retinopathy complications, hypoglycaemia then avoid taking such medications.
• This not for Type I diabetes i.e., diabetic ketoacidosis.
• Pregnant women should avoid taking any such medications.