Semaglutide injections Wake Forest, NC - Vitality Hormone Clinic

Introduction to Semaglutide

Semaglutide is an incretin mimetic, glucagon-like peptide-1 (GLP-1) receptor agonist that is administered once-weekly by subcutaneous injection to improve glycemic control in adults with type 2 diabetes. It mimics the effects of GLP-1, a hormone released from the gastrointestinal tract in response to food intake that increases insulin secretion, suppresses glucagon secretion, and slows gastric emptying.

Semaglutide was approved by the FDA in 2017 and has been shown in clinical trials to be highly effective at lowering HbA1c and fasting blood glucose levels in patients with type 2 diabetes. Some of the main benefits of semaglutide therapy include:

• Significant reductions in HbA1c levels - In clinical trials, semaglutide lowered HbA1c by up to 1.8% from baseline when used as monotherapy or in combination with other diabetes medications.
• Weight loss - Semaglutide often leads to moderate weight loss, with an average loss of 4.3 to 13 lbs reported in clinical trials. This can help improve insulin sensitivity.
• Low risk of hypoglycemia - Semaglutide does not typically cause blood sugar to drop dangerously low when used alone. The risk increases when combined with medications like sulfonylureas.
• Convenient weekly dosing - Only needing one injection per week improves compliance over daily or twice daily GLP-1 drugs.
• Cardiovascular benefits - Semaglutide has been shown to reduce the risk of cardiovascular events like stroke and heart attack in patients with type 2 diabetes and high CV risk.

Semaglutide is an important new option in the treatment of type 2 diabetes, especially for patients struggling with high blood sugars despite using other medications. Vitality Hormone Clinic provides semaglutide injections and ongoing diabetes care and education in Wake Forest, North Carolina.

Who is a Candidate for Semaglutide?

Semaglutide may be an appropriate treatment option for adults with type 2 diabetes that are not achieving their target blood sugar levels with lifestyle modifications and other oral medications. Ideal candidates include:

• Patients with an HbA1c over 7% (or over an individualized target) on their current diabetes regimen
• Patients who need assistance losing a significant amount of weight
• Patients who experience frequent hypoglycemia on medications like sulfonylureas
• Patients with established cardiovascular disease who may benefit from semaglutide's cardiovascular protective effects

Semaglutide should not be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2. It should be used with caution in patients with kidney impairment, diabetic retinopathy, gastrointestinal disease, or congestive heart failure.

Patients do not need to fail other medications first to be a candidate for semaglutide, as it can be used as monotherapy or as an add-on treatment to oral medications or insulin. Semaglutide is not just for patients with uncontrolled diabetes - it can also help patients meet tighter glycemic targets or assist with weight loss goals.

How Semaglutide Works to Control Blood Sugar

Semaglutide helps improve blood sugar control through several mechanisms of action:

• Increases insulin secretion - Semaglutide stimulates the pancreas to secrete more insulin when blood glucose levels are elevated. This promotes glucose uptake by cells.
• Decreases glucagon secretion - It inhibits the secretion of glucagon, a hormone that raises blood glucose. Lower glucagon means less glucose is released by the liver.
• Slows gastric emptying - By slowing the rate at which food empties from the stomach, semaglutide blunts the postprandial glucose spike that follows meals.
• Increases satiety - Semaglutide impacts appetite regulation, leading to decreased food intake, reduced body weight, and improved insulin sensitivity.

The combination of these effects enables semaglutide to lower HbA1c and fasting glucose substantially in patients with type 2 diabetes. It works to restore first phase insulin response, suppress inappropriately high glucagon secretion, and reduce caloric intake – together improving glycemic control.

Dosing, Administration and Duration of Semaglutide

Semaglutide is given as a once-weekly subcutaneous injection, with a recommended starting dose of 0.25 mg. The dose is increased to 0.5 mg after 4 weeks, then to 1 mg after another 4 weeks (if needed to further improve control or assist with weight loss goals).

The semaglutide pen injector is easy to learn to use. The injections are administered under the skin of the abdomen, thigh, or upper arm. Rotation of injection sites is recommended with each dose.

Most patients will reach a maintenance dose of 1 mg weekly. The effects of each dose last about a week, providing 24/7 blood sugar lowering coverage with the convenience of once-weekly dosing.

There is no fixed duration for semaglutide treatment. It can be taken long-term as long as it continues providing benefits such as acceptable blood sugar control, weight loss, reduced cardiovascular risk, or avoidance of hypoglycemia.

If semaglutide is discontinued, its effects wear off over several weeks. Blood glucose and A1c levels will likely rise back to pre-treatment elevations.

Efficacy of Semaglutide in Clinical Trials

Extensive clinical research has demonstrated that semaglutide is highly effective at lowering blood glucose and A1c in patients with type 2 diabetes. Key findings on its efficacy include:

• As a monotherapy, semaglutide reduced A1c by 0.8-1.6% compared to placebo over 26-56 weeks.
• In combination with 1-2 other oral diabetes medications, it lowered A1c by 1.3-1.7% vs. placebo over 56 weeks.
• Semaglutide was superior to sitagliptin, exenatide ER, and insulin glargine in reducing A1c as add-on treatments.
• It produced greater A1c reductions compared to other GLP-1 receptor agonists like liraglutide and dulaglutide.
• Over 80% of patients achieved an A1c under 7% with semaglutide vs. only ~30% with placebo.
• Significant weight loss of around 10-13 lbs was seen with semaglutide vs. 2-6 lbs of weight gain with placebo.
• Patients reported improved quality of life and treatment satisfaction with semaglutide.

This robust evidence demonstrates semaglutide is one of the most effective GLP-1 medications for improving glycemic control and assisting with weight loss in type 2 diabetes. The effects are proven with semaglutide as monotherapy or add-on therapy.

Cardiovascular Benefits of Semaglutide

A large clinical trial called SUSTAIN 6 evaluated the cardiovascular safety and outcomes of semaglutide vs. placebo in adults with type 2 diabetes. Some highlights of the findings include:

• Semaglutide significantly reduced the risk of major cardiovascular events like stroke, heart attack, and cardiovascular death by 26%.
• The risk of nonfatal stroke was reduced by 39% compared to placebo.
• Heart attack risk decreased by 26% with semaglutide.
• Risk of new or worsening kidney disease was also substantially lower with semaglutide.
• Rates of diabetic retinopathy complications were 22% lower than the placebo group.

The researchers concluded semaglutide has robust cardioprotective effects in patients with type 2 diabetes, above and beyond its glucose lowering action. The reasons are likely multifactorial - improved glucose control, weight loss, blood pressure reduction, and other positive effects on cardiovascular risk factors.

Side Effects and Safety Concerns with Semaglutide

The most common side effects with semaglutide are gastrointestinal in nature, as it slows gastric emptying and impacts gut hormones:

• Nausea - The most frequent side effect. It is usually mild to moderate and resolves within 4-8 weeks as tolerance develops. Taking with food may help.
• Vomiting and diarrhea - Also common, especially when initiating treatment. The symptoms typically improve over time.
• Decreased appetite - Semaglutide curbs appetite, often leading to weight loss. This is generally considered a beneficial effect in most patients.
• Constipation - May occur due to slowed gastric motility. Increased hydration and fiber can help relieve symptoms.
• Abdominal pain - Can accompany nausea/vomiting, but should subside. Severe pain warrants physician follow up.

Hypoglycemia is uncommon with semaglutide monotherapy but can occur when combined with insulin or insulin secretagogues like sulfonylureas. Medication adjustments may be required to reduce hypoglycemia risk.

Semaglutide has not been shown to increase risk of thyroid C-cell tumors, pancreatitis, or other serious adverse effects. It should not be used in patients at risk for medullary thyroid carcinoma. Kidney function should be monitored, as GLP-1 drugs can slightly increase serum creatinine levels.

Lifestyle Recommendations with Semaglutide Therapy

Semaglutide is most effective when combined with a healthy lifestyle approach to managing type 2 diabetes. Recommendations include:

• Following a balanced, nutrient-dense diet - Focus on whole foods like fruits, vegetables, fiber-rich grains, healthy fats and lean proteins. Avoid added sugars and processed items.
• Getting regular exercise - Aim for 150 minutes per week of moderate activity like walking, cycling or water workouts. Strength training provides added benefits.
• Reaching and maintaining a healthy body weight - Semaglutide facilitates weight loss to improve diabetes control and insulin sensitivity.
• Quitting smoking - Smoking increases cardiovascular risk and diabetes complications. Work closely with your healthcare provider to successfully quit.
• Limiting alcohol - Heavy alcohol use is harmful for diabetes. Moderation is advised - no more than 1 drink daily for women, 2 for men.
• Managing stress - Unmanaged stress and anxiety negatively impact diabetes. Try relaxation techniques, mind-body practices, or counseling when needed.

Combining semaglutide with therapeutic lifestyle changes gives the best chance of achieving hemoglobin A1c goals and reducing risks of diabetic complications. Healthy behaviors also support mental health on this journey.

Why Choose Vitality Hormone Clinic for Semaglutide Injections?

The endocrinology experts at Vitality Hormone Clinic in Wake Forest, North Carolina provide cutting-edge, evidence-based care for patients with diabetes and other hormone disorders. Key reasons to choose us for semaglutide therapy include:

• Extensive experience managing diabetes with GLP-1 receptor agonists and insulin therapy
• Close monitoring and medication adjustments to optimize A1c and weight loss results
• Ongoing diabetes education and lifestyle counseling
• A team approach - endocrinologists, diabetes educators, dietitians and mental health support
• Proficiency training patients on injecting semaglutide pens
• Support with insurance coverage and affordability issues
• Convenient telehealth visits available along with in-person care
• Individualized treatment plans to meet each patient’s health goals

At Vitality Hormone Clinic, your endocrine health is our passion. We look forward to partnering with you on your journey to better health with semaglutide and comprehensive diabetes care.