Real-world Canadian Retrospective Study Evaluating Longitudinal Semaglutide Use on Cardio-Kidney-Metabolic Outcomes

The goal of this study is to better understand the real-world effectiveness of semaglutide use on cardio-kidney-metabolic outcomes among adults with T2D and adults with obesity (without diabetes mellitus). This is a retrospective longitudinal analysis using the LMC Diabetes Registry. The primary outcome of the study is to evaluate the change in HbA1c between baseline to 3 years of follow-up among adults with T2D who initiated semaglutide compared to adults with T2D who initiated other AHAs, including sulfonylurea, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors.

Inclusion Criteria: T2D Cohort: * A clinical diagnosis of T2D ≥ 1 year * HbA1c ≥ 6.5% (pre-index date) * Initiated semaglutide or other AHA(s) before January 1st, 2023\* * Seen by an LMC endocrinologist in the last 18 months as of the query date * ≥ one HbA1c value up to 6 months (+ 90 days) prior to index date * Informed data consent for their medical record data to be used for research purposes Obesity Cohort: * 18 years or older * BMI ≥ 27 kg/m2 * HbA1c \< 6.5% (pre-index date) * Initiated semaglutide before January 1st, 2023\* * Seen by an LMC endocrinologist in the last 18 months as of the query date * ≥ one HbA1c value up to 6 months (± 90 days) prior to index date * Informed data consent for their medical record data to be used for research purposes Exclusion Criteria: * Clinical diagnosis of type 1 diabetes/latent autoimmune diabetes in adults (LADA) * Clinical diagnosis of T2D (obesity cohort only) * Are pregnant at the time of semaglutide or other AHA initiation or became pregnant during follow-up period * Documented history or family history of medullary thyroid carcinoma * Participation in a research study with an Investigational Product * eGFR \< 15 mL/min/1.73m2 at index date * Use of non-semaglutide GLP-1-based medication for more than 6 months after the index date (T2D sema cohort and obesity sema cohort) * Use of other AHA for more than 6 months after the index date within the first year of semaglutide use (T2D sema cohort and obesity sema cohort)