Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
More than 1 in 3 American adults has prediabetes, and losing weight can decrease the risk of progressing to type 2 diabetes by 50%. The impact of pharmacist-driven medication-assisted weight loss for diabetes prevention is unknown.
Research Question or Hypothesis: Can pharmacist-driven use of subcutaneous semaglutide for prediabetes, impaired fasting glucose, or overweight/obesity improve weight, hemoglobin A1c (HbA1c), blood pressure (BP), and low-density lipoprotein (LDL) over a one-year period?
Study Design: Retrospective single-center pre-post study
Methods: Electronic medical records of an ambulatory care clinic were reviewed to identify people who had subcutaneous semaglutide initiated for prediabetes, impaired fasting glucose, or overweight/obesity by a pharmacist in 2021. Diabetes diagnosis and pregnancy were exclusion criteria. The primary outcome was weight change from baseline to one year after semaglutide initiation (follow-up). Secondary outcomes were changes in HbA1c, BP, and LDL from baseline to follow-up, as well as percentage of participants with HbA1c <5.7% at follow-up. Paired t-tests were used via R statistical software to assess average change from baseline to follow-up with alpha 0.05.
Results: Sixty-three participants (mean age 58.9 years, 56% female, 76% white) were included. Mean baseline weight was 236.6 pounds, HbA1c 6.0%, BP 130/81 mmHg, and LDL 114.3 mg/dL. There was a significant change from baseline for weight (-17.8 pounds, p<0.0001, n=54), HbA1c (-0.34%, p=0.0012, n=16), systolic BP (-8 mmHg, p<0.0001, n=54), and LDL (-12.7 mg/dL, p<0.015, n=50). Of the 20 participants with baseline HbA1c, 17 (85%) had HbA1c consistent with prediabetes (5.7%-6.4%). Of the 28 participants with follow-up HbA1c, 11 (39%) had HbA1c consistent with prediabetes, whereas 16 (57%) had HbA1c <5.7% and 1 (4%) had HbA1c >6.4%.
Conclusion: Pharmacist-driven use of subcutaneous semaglutide in people without diabetes led to improvements in metabolic parameters of weight, HbA1c, systolic BP, and LDL. Future studies will further elucidate the role of pharmacist-driven use of semaglutide for diabetes prevention.
Presenting Author
Kaely G. Miller MBA, PharmD CandidateHigh Point University Fred Wilson School of Pharmacy
Authors
Kelsy Combs PharmD, BCPS, BCACP, CPP
Greensboro Medical Associates
Danyelle Thompson PharmD Candidate
High Point University Fred Wilson School of Pharmacy
Scott J. Richter PhD
University of North Carolina at Greensboro
Christina H. Sherrill PharmD, BCACP, BC-ADM, CPP
High Point University Fred Wilson School of Pharmacy