Novo Nordisk India launched 'peptide in a pill', oral semaglutide for diabetes management. Semaglutide, a GLP-1 receptor analogue (GLP-1 RA) – one of the drug classes to treat diabetes, till now was available only in the form of injections. 

Oral semaglutide is a co-formulation of GLP-1RA semaglutide with an absorption enhancer SNAC which protects semaglutide from undergoing degradation in the stomach like other peptides and enhances its absorption. 

It has undergone 10 rigorous phase 3a clinical trials called PIONEER, across several countries including India. The completed and ongoing global trials with oral semaglutide includes more than 10,000 patients of which more than 1,000 participants are from India. In addition to the unprecedented glycemic control, oral semaglutide demonstrated unsurpassed weight loss and consistent cardiovascular safety in clinical trials. Oral semaglutide has been approved by the Drugs Controller General of India (DCGI) in 2020. Oral semaglutide, which is indicated for glycaemic control in adults with type 2 diabetes, is expected to be a gamechanger and a life changer in diabetes management.  

Speaking at the launch, Vikrant Shrotriya, Corporate Vice President and Managing Director, Novo Nordisk India, said, “We are extremely proud and elated to launch oral semaglutide in India. With a strong clinical profile, we believe, it has the potential to revolutionise the treatment of type 2 diabetes, given that millions of people do not achieve the targeted blood sugar levels with currently available oral antidiabetic medications. Its launch coincides with our hundred-year centenary of insulin discovery, that changed the life of people with diabetes needing insulin. Likewise, we believe, semaglutide in oral form will transform the management of diabetes.”

Dr Shashank Joshi, Chair IDF Southeast Asia and Consultant Endocrinologist at Lilavati Hospital, Bhatia Hospital & Joshi Clinic, Mumbai said, "Glucagon-like peptide 1 (GLP-1) is a naturally occurring hormone and plays an important role in maintaining the normal level of glucose in the blood. Peptide and protein-based biological medicines are typically very effective, their only drawback being delivered as injectables. This can be a barrier to optimal diabetes management, as many people prefer pills over injections. Oral semaglutide represents a game changing innovation for both patients and HCPs in the field of diabetes, with the ease of oral administration combined with the benefits of a GLP-1 RA. It delivers unprecedented HbA1c control and unsurpassed weight loss, with a well-established safety profile consistent with the GLP-1 RA class3-8.”

Dr Vinay Kumar Bahl, Principal Director, Cardiology, Max Hospital, Delhi said, "When diabetes is undetected and inadequately treated, patients are at higher risk of serious and life-threatening complications, such as heart attack, stroke, kidney failure, blindness and lower-limb amputation. These complications result in reduced quality of life and impose higher healthcare costs. The actions of GLP-1RAs go beyond their effects on blood sugar and body weight, also proven to be beneficial to the cardiovascular system."

Dr V Mohan, Chairman, Dr Mohan's Diabetes Specialities Centre, Chennai said, "People with diabetes and obesity are at increased risk of COVID-19 related complications and mortality. Availability of a drug which can improve both blood glucose and body weight, will be like hitting two targets with one arrow."

Globally, over 90 per cent of people with diabetes have type 2 diabetes. The rise in the number of people with type 2 diabetes is driven by a complex interplay of socio-economic, demographic, environmental and genetic factors. Key contributors include urbanization, an aging population, decreasing levels of physical activity and increasing prevalence of overweight and obesity. Currently, in India 1 in 12 adults (20-79 years) are living with diabetes.12 On an average, 50 per cent of people with type 2 diabetes (T2D) taking three or more oral anti-diabetes drugs (OADs) do not achieve target blood sugar levels. Moreover, 77 per cent fail to achieve glycaemic goals while majority struggle with a high average HbA1c of 8.6 per cent uncontrolled blood sugar, excess weight and increased cardiovascular risk further contribute to premature death and diabetes-related complication.Early detection and treatment are the need of the hour in effectively managing the increasing diabetes population and further reducing co-morbidities.