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Semaglutide is particularly beneficial for patients with difficulty achieving blood sugar control through other means and those who may also benefit from weight loss as part of their diabetes management
Assessment considerations include: Serum B12 measurement may be considered before initiating Ozempic in high-risk patients (those on metformin, older adults, those with gastrointestinal symptoms, or with restricted diets) Testing for B12 deficiency should be performed in patients on metformin who develop symptoms suggestive of deficiency, as advised by the MHRA Drug Safety Update Consider periodic monitoring in patients with risk factors for B12 deficiency, rather than routine annual testing for all patients Full blood count to identify macrocytic anaemia, which may indicate B12 or folate deficiency Clinical assessment for symptoms of deficiency: fatigue, paraesthesia, cognitive changes, glossitis, or balance problems If B12 levels are borderline or if clinical suspicion remains despite normal serum B12 (measured in pmol/L, with laboratory-specific reference ranges), additional testing may be considered according to local laboratory protocols
Secondary outcomes include change in waist circumference, change in BMI, change in percent body fat, change in visceral and subcutaneous adipose tissue, change in trunk fat mass, percentage of weight loss due to fat mass or lean mass, quality of life, and more
Injection site reactions are the most commonly reported dermatological effects with subcutaneous semaglutide (Ozempic and Wegovy) and typically present as redness, itching, bruising, or mild swelling at the site of administration
