Page 27 - GHES-3-3

Global Health Economics and
Sustainability
Semaglutide for treating T2D and obesity

in chronic hyperglycemia (Durden et al., 2019). Genetic economic burden stemming from this disease includes
susceptibility, coupled with environmental factors – lost income, absenteeism from work, reduced productivity,
most notably obesity – contributes to decreased insulin early retirement, reduced life expectancy, as well as
sensitivity in peripheral tissues (Galicia-Garcia et al., effects of morbidity, disability, and mortality, all of which
2020). In the early stages, pancreatic β-cells compensate contribute to a lower quality of life with T2D. Expanding
by increasing insulin secretion to maintain glucose our understanding of the epidemiological aspects of T2D
homeostasis. However, persistent hyperglycemia and is vital, and recent studies have timely provided valuable
elevated circulating oxidized lipids induce oxidative insights into these trends (Pantanetti et al., 2024, Pantanetti
stress and chronic low-grade inflammation, exacerbating et al., 2024).
β-cell dysfunction. In addition, prolonged hyperglycemia In terms of prevalence, Type 1 diabetes accounts for
stimulates the co-secretion of islet amyloid polypeptide, 5 – 7% of total cases, and gestational diabetes mellitus
leading to amyloid deposition within pancreatic islets. This constitutes about 2 – 3%, while T2D is the most common
amyloid accumulation further impairs β-cell viability and type of diabetes. T2D represents approximately 95% of all
function, ultimately resulting in reduced insulin secretion diabetes cases in the United States (Durden et al., 2019).
and progressive deterioration of glycemic control (Galicia- In 2023, T2D accounted for roughly 90 – 95% of the more
Garcia et al., 2020).
than 37 million diabetes cases in the United States (Lv et al.,
T2D is diagnosed based on criteria established by the 2024), with its prevalence ranging from 9.4% to 14%. The
American Diabetes Association, which take into account increasing prevalence of T2D raises significant concerns
glucose and glycated hemoglobin A1c (HbA1c) levels about the escalating costs of treating complications
(American Diabetes Association Professional Practice (Patel et al., 2023). These concerns extend beyond the
Committee, 2025a). Without proper treatment, T2D can sustainability of the healthcare systems – manifested by
progressively lead to damages to multiple organs and higher pharmaceutical expenses and hospitalization costs
systems, including the cardiovascular system, the eyes, – and impact society at large.
the kidneys, and the nerves (Haddad et al., 2023). Thus,
maintaining long-term glycemic control is crucial, as 2. Methods
it helps reduce the risk of microvascular complications In alignment with the current SANRA methodology,
(Garcia-Casares et al., 2023). this review is deemed significant due to the prevalence
T2D represents a growing epidemiological concern, of diabetes, particularly T2D, and obesity, alongside
given its rising prevalence and associated economic and the development of new antidiabetic therapies such as
societal burdens. In 2021, approximately 537 million semaglutide. The review compares semaglutide with other
(10.5%) adults aged 20 – 79 worldwide were diagnosed treatments and addresses the potential financial savings it
with diabetes, a number expected to rise to 643 million by could offer to the national healthcare systems. The aim of
2030 and to 783 million (12.2%) by 2045 (Hu et al., 2023). this review is to assess the clinical and financial benefits of
In Italy for instance, the prevalence of diabetes in 2019 was semaglutide for patients with T2D and obesity and explore
6.5% in males and 5.9% in females (Ciardullo et al., 2024). how these patients, particularly those with T2D, afford
The global impact of diabetes is further underscored by these therapies, given their relatively high cost.
mortality rates; in 2019, diabetes mellitus was identified as For the literature search strategy, published studies
the cause of 1.5 million deaths, with an additional 460,000 were sourced from databases such as Google Scholar
deaths attributed to kidney disease and 20% of deaths and PubMed, focusing on diabetes and its association
linked to cardiovascular disease (Patel et al., 2023). Given with obesity. A thorough review of the effectiveness of
that nearly 11% of the population in the United States
is affected by diabetes, prioritizing the management of semaglutide compared to other antidiabetic treatments
was conducted, including its clinical efficacy and financial
the disease and its complications is essential to conserve viability within healthcare systems. Only primary research
valuable healthcare resources (D’Andrea et al., 2023).
Treating diabetes and its complications is a growing effort studies that have been published or translated into English,
of public health significance since an estimated total global with available full texts, were included in the review. The
screening process involved searching titles, abstracts, and
health expenditure of USD 966 billion was spent in 2021
(Ciardullo et al., 2024). However, an estimated 33% of full texts, ensuring they were relevant to the research topic.
individuals with diabetes remain undiagnosed; even so, The key arguments of the manuscript – concerning
over 23 million people in the United States receive medical diabetes, obesity, and semaglutide – are supported by
treatment for glycemic control (Weiss et al., 2020). The references.

Volume 3 Issue 3 (2025) 19 https://doi.org/10.36922/ghes.8547