Clinical Improvement of Weight, HbA1c and Liver Function by Rybelsus (Oral Semaglutide) In Patient with Type 2 Diabetes (T2D), Obesity and Fatty Liver

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Background: As glucagon-like-peptide 1 receptor agonist (GLP1-RA), oral semaglutide (Rybelsus) has been latest topic. Case presentation: Patient is 72-year-old male with T2D, obesity, fatty liver and hypertension. He showed BMI 32.4 kg/m2 and HbA1c 8.1% in Nov 2021. Results: He started Rybelsus 3-7mg/day, and HbA1c and weight decreased for 8.1% to 7.0% and 92kg to 86.5kg with ALT/GGT improvement without gastrointestinal adverse events (GIAEs). Discussion: This case has arteriosclerotic cardiovascular disease (ASCVD). From cardiovascular outcome trials (CVOTs), semaglutide group revealed lower odd ratio (OR) for less CV death, as 0.47 of exenatide, 0.46 of dulaglutide and 0.43 of lixisenatide.

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