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Oral semaglutide and SGLT2 inhibitors demonstrate comparable glycemic and weight benefits in individuals with type 2 diabetes, but differ in their impact on skeletal muscle mass.
In patients with type 2 diabetes (T2D), oral semaglutide matches sodium–glucose cotransporter 2 (SGLT2) inhibitors for blood sugar and weight reduction while better preserving skeletal muscle mass, as deciphered from the outcomes of a study published in "Journal of Diabetes Investigation".
This retrospective observational study was carried out to compare the clinical impact of oral semaglutide and SGLT2 inhibitors. Patients with T2D who initiated either oral semaglutide or SGLT2 inhibitor therapy and continued treatment for at least six months were enrolled. Clinical outcomes, including glycemic control, body weight, fat mass, and skeletal muscle mass, were evaluated and compared between both treatment groups using retrospective data analysis.
At 6 months, both oral semaglutide (84 patients) and SGLT2 inhibitors (231 patients) remarkably improved glycemic control while reducing body weight and fat mass. However, oral semaglutide largely preserved skeletal muscle mass, whereas SGLT2 inhibitor therapy was associated with a significant loss of skeletal muscle mass (Table 1).
Hence, while oral semaglutide and SGLT2 inhibitors offer comparable benefits for glycemic control and weight reduction, clinicians must consider the potential for skeletal muscle loss when prescribing SGLT2 inhibitors, particularly in those vulnerable to sarcopenia or frailty. The findings underscore the growing importance of assessing body composition changes—not just weight loss alone—when choosing diabetes care for long-term management.
Journal of Diabetes Investigation
Retrospective comparison of the clinical effects of oral semaglutide and SGLT2 inhibitors treatment in patients with type 2 diabetes
Yasuhiro Omori et al.
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