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Aims  To investigate real‐world short‐term clinical outcomes in adults with type 2 diabetes (T2D) who initiated semaglutide in a specialist endocrinology practice in Canada.    Materials and methods  This study was a retrospective observational study using data from the Canadian LMC Diabetes Registry. Adults with T2D who were naïve to glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) therapy, initiated semaglutide therapy as usual standard of care between February 2018 and February 2019, and maintained semaglutide therapy during follow‐up, were eligible for analysis. The primary outcome was mean change in glycated haemoglobin (HbA1c) at 3‐ to 6‐month follow‐up.    Results  In the final analytical cohort (n = 937), there was a statistically significant mean ± SD reduction in HbA1c of −1.03 ± 1.24% (11.3 ± 13.6 mmol/mol,  P  < 0.001) and weight of −3.9 ± 4.0 kg ( P  < 0.001), with no significant change in self‐reported incidence of hypoglycaemia. There was a significant reduction in HbA1c and weight regardless of number of co‐therapies or semaglutide dose. However, adults using the 1.0‐mg dose had a significantly greater reduction in HbA1c compared to adults using the 0.25‐ to 0.5‐mg dose (between‐group difference − 0.24 ± 0.06%, 2.6 ± 0.7 mmol/mol;  P  < 0.001). Adults using basal‐bolus therapy required a significantly lower median total daily dose of insulin after adding semaglutide (0.82 vs. 0.93 U/kg;  P  < 0.001).    Conclusions  This retrospective observational study demonstrated that GLP‐1RA‐naïve adults with T2D initiating semaglutide in a real‐world clinical practice had a statistically and clinically significant reduction in HbA1c and body weight after 3 to 6 months, regardless of semaglutide dose or order of semaglutide therapy, with no significant change in reported incidence of hypoglycaemia.

Semaglutide once weekly in people with type 2 diabetes: Real‐world analysis of the Canadian LMC diabetes registry ( SPARE study)