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The 12 mg dose escalation group achieved a 2.02% reduction in HbA1c at 24 weeks, along with 16.94% body weight loss at 36 weeks
Paradoxically, just after toxicity onset, there may be brief hypertension or fast heart rate, followed by severe hypotension
Compared with native GLP-1 which has a half-life of only a couple of minutes because the enzyme DPP-4 rapidly inactivates it semaglutide carries an Aib substitution at position 8 that resists DPP-4 cleavage, plus a C18 fatty-diacid side chain that binds albumin and extends its half-life to about a week
However, this strategy has poor efficacy for complex diseases such as schizophrenia, multiple sclerosis (MS), and cancer
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