Semaglutide: Mechanism, Uses, Significance, Side-effects & Challenges

Why in News ?

• Hyderabad-based Natco Pharma has recently received approval from the Central Drugs Standard Control Organization (CDSCO) to manufacture and market a generic Semaglutide injection in India.
• Earlier, the drug was extremely expensive and accessible only to a limited population.
• Generic availability may significantly transform diabetes and obesity management in India.

What is Semaglutide ?

Semaglutide is an anti-diabetic and anti-obesity medication belonging to the class of drugs called GLP-1 Receptor Agonists (GLP-1 RA).

What is GLP-1 ?

GLP-1 (Glucagon-Like Peptide-1) is a hormone released from the intestine after eating.
It helps regulate blood sugar, appetite, and metabolism.

Mechanism of Action

Semaglutide mimics the natural GLP-1 hormone in the body:

Therefore, it is considered a metabolic disease drug, not just a sugar-control medicine.

Therapeutic Uses (Indications)

(A) Type-2 Diabetes

• Controls blood glucose
• Reduces insulin resistance
• Effective in long-term HbA1c reduction

(B) Cardiovascular Risk Reduction

In adults with diabetes + heart disease:

• Reduces heart attack risk
• Reduces stroke risk
• Lowers cardiovascular mortality

(C) Kidney Disease

In Type-2 diabetes with kidney involvement:

• Slows kidney failure progression
• Reduces death risk

(D) Obesity Treatment

WHO recognizes obesity as a chronic metabolic disease.

Semaglutide:

• Suppresses appetite
• Reduces calorie intake
• Produces 10–20% weight loss in clinical trials

 Often called a “medical weight-loss revolution therapy.”

Global Significance

Semaglutide is termed a “weight-loss revolution drug” due to:

• Global obesity epidemic
• Rising diabetes burden
• Increasing lifestyle diseases

Importance for India

• India is often called the diabetes capital of the world (International Diabetes Federation estimates)
• Rising obesity & cardiovascular diseases make this drug highly relevant.

Available Forms

• Weekly injection
• Oral tablet (available in some countries)

Side Effects

Importance for India

1. Generic Availability

Approval for Natco Pharma may:

• Reduce cost
• Improve middle-class access
• Enable public health program use

2. Role in NCD Control

Helps control:

• Diabetes
• Obesity
• Cardiovascular diseases

Challenges

• Not a substitute for lifestyle modification
• Long-term safety data still evolving
• Risk of misuse for cosmetic weight loss
• Dependence on expensive chronic therapy