{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T12:06:23Z","timestamp":1779797183329,"version":"3.53.1"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Several studies have demonstrated that adding semaglutide to the treatment of patients with type 2 diabetes mellitus (T2DM) reduces insulin requirements and glycated hemoglobin (HbA1c) levels. This study aimed to investigate real-world evidence for the effects of semaglutide dose escalation on HbA1c, body weight, dyslipidemia, and insulin dose reduction in patients with T2DM in the Cukurova region of T\u00fcrkiye. Methods: This retrospective cohort study enrolled 500 patients (255 male, 245 female; mean age 56.1 \u00b1 10.8 years) who initiated semaglutide therapy for T2DM between 2024 and 2025. Patients were grouped according to their maximum semaglutide dose: 0.25 mg (Group I), 0.50 mg (Group II), and 1.00 mg (Group III). The primary endpoint was the change in HbA1c from baseline to end of study (30 weeks) across semaglutide dose escalation groups. Secondary endpoints included changes in body weight, frequency of insulin dose reduction, and effects on lipid parameters. Results: A total of 117 patients (23.4%) discontinued semaglutide therapy, while 383 patients (76.6%) completed the study. The primary endpoint revealed a mean HbA1c reduction of \u22121.03 \u00b1 0.35% from baseline to end of study (95% CI 0.99\u20131.07; t = 58.644; p &lt; 0.001). Reductions in HbA1c increased progressively from Group I to Group III (HbA1c: \u22120.72 \u00b1 0.28, \u22121.02 \u00b1 0.26, \u22121.27 \u00b1 0.34%). Insulin dose reduction frequency increased significantly from Group I to Group III (40%, 41%, and 51%, respectively; p = 0.010), with a statistically significant difference only between Group I and Group III. At the end of follow-up, rates of hypoglycemic episodes and gastrointestinal (GI) adverse events were similar across groups. Conclusions: In a real-world population from the Cukurova region of T\u00fcrkiye, semaglutide dose escalation in T2DM patients achieved clinically meaningful glycemic control, body weight reduction, LDL-cholesterol lowering, and a significant increase in insulin dose reduction frequency, without a significant increase in GI adverse events.<\/jats:p>","DOI":"10.3390\/jcm15114105","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:02:51Z","timestamp":1779793371000},"page":"4105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the Efficacy of Semaglutide Dose Escalation in Reducing HbA1c Levels and Insulin Dose in Type 2 Diabetes Patients: Real-World Semaglutide Data from T\u00fcrkiye, SEMA-TR Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7192-0280","authenticated-orcid":false,"given":"Hilmi Erdem","family":"Sumbul","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9553-722X","authenticated-orcid":false,"given":"Bektas","family":"Isik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Gazi","family":"Mustan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Alisan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cigdem","family":"Erhan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seyhan State Hospital, Adana 01150, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma Inci","family":"Koca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seyhan State Hospital, Adana 01150, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysenur","family":"Ucar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yuregir State Hospital, Adana 01240, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8665-152X","authenticated-orcid":false,"given":"Mehmet","family":"Erdevir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yuregir State Hospital, Adana 01240, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6149-9341","authenticated-orcid":false,"given":"Begum Seyda","family":"Avci","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2420-1002","authenticated-orcid":false,"given":"Merve","family":"Saracoglu Sumbul","sequence":"additional","affiliation":[{"name":"Department of Public Health, Adana City Research and Training Hospital, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilan Damla","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yuregir State Hospital, Adana 01240, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-4651","authenticated-orcid":false,"given":"Mustafa Lutfullah","family":"Ardic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5713-004X","authenticated-orcid":false,"given":"Huseyin Ali","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih Necip","family":"Ar\u0131c\u0131","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cahit","family":"Dincer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kubilay","family":"Akbal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, 5 Ocak State Hospital, Adana 01210, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okan","family":"Pirinci","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Duzici State Hospital, Osmaniye 80600, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0444-674X","authenticated-orcid":false,"given":"Fadime","family":"Koca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cukurova State Hospital, Adana 01170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3000-4200","authenticated-orcid":false,"given":"Mevlut","family":"Koc","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Health Sciences, Adana Health Practice and Research Center, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2022). 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