The goal of this study is to better understand the real-world effectiveness of semaglutide use on cardio-kidney-metabolic outcomes among adults with T2D and adults with obesity (without diabetes mellitus). This is a retrospective longitudinal analysis using the LMC Diabetes Registry. The primary outcome of the study is to evaluate the change in HbA1c between baseline to 3 years of follow-up among adults with T2D who initiated semaglutide compared to adults with T2D who initiated other AHAs, including sulfonylurea, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors.
Study Type
OBSERVATIONAL
Enrollment
400
participants who initiate semaglutide
Change in HbA1c- 3 Years
The primary outcome measure is investigating the change in HbA1c from baseline to 3 years (± 90 days) among adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs
Time frame: Baseline to 3 Years
Change in HbA1c- 1 Year
Comparing the change in HbA1c between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 year
Change in HbA1c- 2 Years
Comparing the change in HbA1c between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Proportion of individuals who achieve HbA1c ≤ 7.0% - 1 Year
comparing the proportion of individuals who achieve HbA1c ≤ 7.0% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Proportion of individuals who achieve HbA1c ≤ 7.0%- 2 Years
comparing the proportion of individuals who achieve HbA1c ≤ 7.0% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Proportion of individuals who achieve HbA1c ≤ 7.0% - 3 Years
comparing the proportion of individuals who achieve HbA1c ≤ 7.0% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in body weight- 1 Year
comparing the change in body weight (kg) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in body weight- 2 Years
comparing the change in body weight (kg) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in body weight- 3 Years
comparing the change in body weight (kg) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Percent body weight loss ≥ 5% - 1 Year
comparing the percent body weight loss ≥ 5% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Percent body weight loss ≥ 5% - 2 Years
comparing the percent body weight loss ≥ 5% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Percent body weight loss ≥ 5% - 3 Years
comparing the percent body weight loss ≥ 5% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Percent body weight loss ≥ 10% - 1 Year
comparing the percent body weight loss ≥ 10% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Percent body weight loss ≥ 10% - 2 Years
comparing the percent body weight loss ≥ 10% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Percent body weight loss ≥ 10% - 3 Years
comparing the percent body weight loss ≥ 10% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Percent body weight loss ≥ 15% - 1 Year
comparing the percent body weight loss ≥ 15% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Percent body weight loss ≥ 15%- 2 Years
comparing the percent body weight loss ≥ 15% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Percent body weight loss ≥ 15%- 3 Years
comparing the percent body weight loss ≥ 15% between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in BMI- 1 Year
comparing the change in BMI (kg/m\^2) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in BMI- 2 Years
comparing the change in BMI (kg/m\^2) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in BMI- 3 Years
comparing the change in BMI (kg/m\^2) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in Waist Circumference- 1 Year
comparing the change in waist circumference (cm) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in Waist Circumference- 2 Years
comparing the change in waist circumference (cm) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in Waist Circumference- 3 Years
comparing the change in waist circumference (cm) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in Blood Pressure- 1 Year
comparing the change in blood pressure between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in Blood Pressure- 2 Years
comparing the change in blood pressure between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in Blood Pressure- 3 Years
comparing the change in blood pressure between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in eGFR- 1 Year
comparing the change in eGFR (ml/min1.73m\^2) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in eGFR- 2 Years
comparing the change in eGFR (ml/min1.73m\^2) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in eGFR- 3 Years
comparing the change in eGFR (ml/min1.73m\^2) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Proportion of individuals with ≥ 50% decline in eGFR- 1 Year
comparing the proportion of individuals with ≥ 50% decline in eGFR between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Proportion of individuals with ≥ 50% decline in eGFR- 2 Years
comparing the proportion of individuals with ≥ 50% decline in eGFR between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Proportion of individuals with ≥ 50% decline in eGFR- 3 Years
comparing the proportion of individuals with ≥ 50% decline in eGFR between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in uACR- 1 year
comparing the change in uACR (mg/mmol) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in uACR- 2 years
comparing the change in uACR (mg/mmol) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in uACR- 3 Years
comparing the change in uACR (mg/mmol) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in ALT- 1 Year
comparing the change in ALT (U/L) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in ALT- 2 Years
comparing the change in ALT (U/L) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in ALT- 3 Years
comparing the change in ALT (U/L) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in Lipids- 1 Year
comparing the change in lipids (triglycerides, low-density lipoprotein cholesterol \[LDL-C\], high-density lipoprotein cholesterol \[HDL-C\], total cholesterol) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in Lipids- 2 Years
comparing the change in lipids (triglycerides, low-density lipoprotein cholesterol \[LDL-C\], high-density lipoprotein cholesterol \[HDL-C\], total cholesterol) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in Lipids- 3 Years
comparing the change in lipids (triglycerides, low-density lipoprotein cholesterol \[LDL-C\], high-density lipoprotein cholesterol \[HDL-C\], total cholesterol) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in number of non-insulin AHAs, excluding GLP-1 based therapies- 1 Year
comparing the change in the number of non-insulin AHAs, excluding GLP-1 based therapies between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in number of non-insulin AHAs, excluding GLP-1 based therapies- 2 Years
comparing the change in the number of non-insulin AHAs, excluding GLP-1 based therapies between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in number of non-insulin AHAs, excluding GLP-1 based therapies- 3 Years
comparing the change in the number of non-insulin AHAs, excluding GLP-1 based therapies between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Number of non-semaglutide GLP-1-based therapies- 1 Year
comparing the number of non-semaglutide GLP-1-based therapies between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Number of non-semaglutide GLP-1-based therapies- 2 Years
comparing the number of non-semaglutide GLP-1-based therapies between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Number of non-semaglutide GLP-1-based therapies- 3 Years
comparing the number of non-semaglutide GLP-1-based therapies between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in insulin use- 1 Year
comparing the change in insulin use (none, basal only, basal-bolus) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in Insulin- 2 Years
comparing the change in insulin use (none, basal only, basal-bolus) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in Insulin- 3 Years
comparing the change in insulin use (none, basal only, basal-bolus) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Change in TDD of insulin- 1 Year
comparing the change in TTD of insulin (U) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 1 year in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 1 Year
Change in TDD of insulin- 2 Years
comparing the change in TTD of insulin (U) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 2 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 2 Years
Change in TDD of insulin- 3 Years
comparing the change in TTD of insulin (U) between adults with T2D who initiated semaglutide compared with adults with T2D who initiated other AHAs at 3 years in the kidney, liver and cardiovascular sub-cohorts
Time frame: Baseline to 3 Years
Incidence of non-acetylsalicylic acid antiplatelet use
comparing the incidence of non-acetylsalicylic acid antiplatelet use between adults with T2D treated with 1 or more years of semaglutide and adults with T2D treated with 1 or more years of other AHAs in the cardiovascular sub-cohort
Time frame: Baseline to Endpoint
Percent body weight loss ≥ 5%
Comparing the percent body weight loss ≥ 5% in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Percent body weight loss ≥ 10%
Comparing the percent body weight loss ≥ 10% in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Percent body weight loss ≥ 15%
Comparing the percent body weight loss ≥ 15% in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Body Weight
Comparing body weight (kg) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
BMI
Comparing BMI (km/m\^2) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Waist Circumference
Comparing the waist circumference (cm) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
HbA1c
Comparing HbA1c (%) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Percent of new onset pre-diabetes
Comparing the percent of new onset pre-diabetes (%) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Percent of new onset T2D
Comparing the percent of new onset T2D (%) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Blood Pressure
Comparing blood pressure in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
eGFR
Comparing eGFR (ml/min1.73m\^2) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 year
uACR
Comparing uACR (mg/mmol) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
ALT
Comparing ALT (U/L) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
Lipids
Comparing lipids (triglycerides, LDL-C, HDL-C , total cholesterol) in the cohort of adults with obesity treated with semaglutide from the index date to 1 year of follow-up (± 90 days)
Time frame: Baseline to 1 Year
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