Journal of diabetes investigation
Parasympathetic dysfunction assessed by deep-breathing CVR-R is associated with early discontinuation of oral semaglutide in type 2 diabetes: A multicenter retrospective study
By Ogiso K, Deguchi T, Kawade S and 3 others.
Abstract
Aims/introduction
Although glucagon-like peptide-1 receptor agonists are widely used for type 2 diabetes, gastrointestinal intolerance frequently leads to early discontinuation. Predictors of oral semaglutide discontinuation remain poorly defined, and its formulation-specific dependence on gastric conditions may influence tolerability. We examined whether the coefficient of variation of R-R intervals (CVR-R) was associated with discontinuation within 6 months.
Materials and methods
In this multicenter retrospective study, 203 consecutive patients initiating oral semaglutide between February 2021 and December 2024 were screened, and 61 were analyzed after exclusions. The Discontinuation Group (n = 21) discontinued because of nausea and/or vomiting within 6 months, whereas the Maintenance Group (n = 40) continued for ≥ 6 months. CVR-R was assessed at rest (CVR-R_rest) and during deep breathing (CVR-R_DB). Associations with discontinuation were evaluated using multivariable logistic regression; exploratory machine learning and time-to-event analyses were performed.