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Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...

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Risk Factors for Hypoglycemia in Type 2 Diabetes Mellitus Patients Using Once-Weekly Semaglutide: A Matched

Palanisamy Amirthalingam1, Fawaz Ahmed Alarawi2, Loay Mohammed Jassas Alagwar2

  • 1Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia.

Therapeutics and Clinical Risk Management
|June 10, 2026
PubMed
Summary
This summary is machine-generated.

Semaglutide once-weekly injection (Sema-OWI) for type-2 diabetes can cause hypoglycemia. Normal BMI and HbA1C levels below 7% are identified as key risk factors for this adverse event.

Keywords:
HbA1Cbody mass indexhypoglycemiasemaglutide once-weekly injectiontype-2 diabetes mellitus

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Semaglutide once-weekly injection (Sema-OWI) is a common treatment for type-2 diabetes mellitus (T2DM), often used for weight management.
  • Hypoglycemia remains a significant clinical challenge in T2DM patients using Sema-OWI.
  • Factors contributing to hypoglycemia in patients on Sema-OWI require further elucidation.

Purpose of the Study:

  • To investigate the patient characteristics associated with hypoglycemia in individuals with T2DM treated with Sema-OWI.
  • To identify risk factors for hypoglycemic events during semaglutide therapy.

Main Methods:

  • A matched case-control study design with a 1:4 case-to-control ratio was utilized.
  • Univariable and multivariable conditional logistic regression analyses were performed.
  • Key variables included body mass index (BMI), glycosylated hemoglobin (HbA1C), number of T2DM medications, and Sema-OWI treatment duration.

Main Results:

  • Obesity and HbA1C levels greater than 9% were associated with a lower likelihood of hypoglycemia.
  • Conversely, normal BMI and HbA1C levels less than 7% were linked to a higher risk of hypoglycemia.
  • Treatment duration exceeding 4-6 months showed a reduced likelihood of hypoglycemia.

Conclusions:

  • Patients with T2DM on Sema-OWI necessitate close monitoring, especially within the initial three months of treatment.
  • Normal body mass index (BMI) and glycosylated hemoglobin (HbA1C) levels below 7% are significant risk factors for hypoglycemia.
  • Understanding these risk factors can aid in proactive management and prevention of hypoglycemic episodes.