Cardiovascular Outcomes with Oral Semaglutide in High-Risk Patients with Type 2 Diabetes

Randomized trials have shown that injected semaglutide lowers risk for adverse cardiovascular events in patients with type 2 diabetes (NEJM JW Gen Med Jul 1 2024 and N Engl J Med 2024; 391:109; NEJM JW Cardiol Nov 2016 and N Engl J Med 2016; 375:1834). To find out if the oral version confers similar benefit, researchers conducted an industry-sponsored randomized trial that involved nearly 10,000 patients with type 2 diabetes.

Enrollment criteria included age ≥50 and history of atherosclerotic cardiovascular (CV) disease or chronic kidney disease; most patients (≈84%) qualified with the CV criterion. At baseline, mean body–mass index was 31 kg/m², mean glycosylated hemoglobin (HbA_1c) was 8%, and median diabetes duration was 15 years. Particip…