Semaglutide 2.4 mg is associated with improved insulin sensitivity and glycemic outcomes among adolescents with obesity, according to study findings published in Diabetes Care.
In type 2 diabetes, a more aggressive disease course is observed among adolescents relative to adults, underscoring the paramount importance of averting diabetes onset in childhood.
In the Semaglutide Treatment Effect in People with obesity (STEP TEENS; Clinical Trials.gov Identifier: NCT04102189) study, adolescents (N=193) were aged 12 to younger than 18 years with a body mass index (BMI) of at least the 95th percentile or at least the 85th percentile plus at least 1 comorbidity. The participants were randomly assigned to receive 2.4 mg semaglutide (n=129) or placebo (n=64) for 68 weeks between 2019 and 2022.
In this secondary analysis, the primary endpoints were the change in insulin sensitivity and cardiometabolic outcomes from baseline to week 68.
These data support semaglutide 2.4 mg as an efficacious weight management treatment for adolescents living with obesity with the added benefit of improvements in insulin sensitivity, glycemic measures, and cardiometabolic risk factors…
The semaglutide and placebo cohorts comprised 62.0% and 60.9% girls, and they had mean (SD) ages of 15.5 (1.5) and 15.3 (1.6) years, BMI of 37.7 (6.7) and 35.9 (5.4), and glycated hemoglobin (HbA1c) of 5.5% (0.3%) and 5.4% (0.3%), respectively.
From baseline to week 68, the adolescents who received semaglutide vs placebo had greater decreases in:
- HbA1c (estimated treatment difference [ETD], -0.2%; 95% CI, -0.29% to -0.14%; P <.0001);
- Homeostatic model assessment for insulin resistance (HOMA-IR) score (ETD, -31.4%; 95% CI, -43.9% to -16.1%; P =.0002);
- Fasting serum insulin (ETD, -26.2%; 95% CI, -38.6% to -11.3%; P =.0012);
- Fasting plasma glucose (ETD, -0.2 mmol/L; 95% CI, -0.31 to -0.03; P =.0181); and,
- Geometric mean alanine aminotransferase (ALT; ETD, -15.1%; 95% CI, -26.3% to -2.2%; P =.0232).
For the cardiometabolic outcomes, semaglutide vs placebo was associated with greater reductions in:
- Waist-to-height ratio (ETD, -0.07; 95% CI, -0.09 to -0.05; P <.0001);
- BMI (ETD, -16.7; 95% CI, -20.4 to -13.1; P <.0001);
- Triglycerides (ETD, -30.2 mmol/L; 95% CI, -38.2 to -21.3; P <.0001);
- Very low-density lipoprotein cholesterol (ETD, -29.5 mmol/L; 95% CI, -37.5 to -20.6; P <.0001);
- Total cholesterol (ETD, -7.3 mmol/L; 95% CI, -10.9 to -3.7; P =.0001); and,
- Low-density lipoprotein cholesterol (ETD, -6.8 mmol/L; 95% CI, -11.6 to -1.6; P =.0105).
In general, the relative changes in all outcomes — except high-density lipoprotein cholesterol levels — were more favorable with greater BMI reductions from baseline.
This study was not designed to evaluate predictors for treatment response.
The study authors concluded, “These data support semaglutide 2.4 mg as an efficacious weight management treatment for adolescents living with obesity with the added benefit of improvements in insulin sensitivity, glycemic measures, and cardiometabolic risk factors, all contributing to improved patient health within clinical practice.”
References:
Arslanian S, Gies I, Goldman B, et al. Effect of semaglutide on insulin sensitivity and cardiometabolic risk factors in adolescents with obesity: the STEP TEENS study. Diabetes Care. 2025:dc250824. doi:10.2337/dc25-0824
