| Variable . | Group . | Intervention . | ETD . | |||
|---|---|---|---|---|---|---|
| Training (n = 15) . | Semaglutide and training (n = 16) . | Semaglutide (n = 12) . | Semaglutide and training (n = 16) . | Training (n = 15) . | ΔSemaglutide and training vs ΔTraining . | |
| . | . | Change (95% CI) . | Change (95% CI) . | Change (95% CI) . | Difference (95% CI) . | |
| Age, years | 56 ± 5.7 | 59 ± 6.2 | — | — | — | — |
| T2D duration, years | 4.2 ± 4 | 5.2 ± 3 | — | — | — | — |
| Body mass, kg | 110.3 ± 21.1 | 111.7 ± 22.3 | −6.7 (−9.9 to −3.5) | −2.2 (−4.2 to −0.2) | −1.2 (−3.3 to 0.9) | −1.0 (−3.5 to 1.5) |
| Height, m | 1.8 ± 0.1 | 1.8 ± 0.1 | — | — | — | — |
| BMI, kg/m2 | 34.6 ± 5.4 | 34.8 ± 4.8 | −2.1 (−3.0 to −1.2) | −0.7 (−1.3 to 0.0) | −0.4 (−1.0 to 0.3) | −0.3 (−1.1 to 0.5) |
| Lean mass, kg | 68.1 ± 11 | 67.3 ± 12.5 | −2.1 (−3.3 to −1.1) | 0.2 (−1.1 to 1.5) | 0.1 (−1.2 to 1.5) | 0.1 (−1.5 to 1.7) |
| Fat mass, kg | 42 ± 13.7 | 43.6 ± 10.9 | −5.2 (−7.8 to −2.5) | −2.1 (−4.0 to −0.2) | −2.4 (−4.3 to −0.5) | 0.3 (−2.0 to 2.7) |
| Visceral fat, kg | 3.4 ± 1.6 | 3.9 ± 1.6 | −0.8 (−1.3 to −0.4) | −0.5 (−0.9 to −0.1) | − 0.3 (−0.8 to 0.1) | −0.2 (−0.7 to 0.4) |
| Body fat percentage, % | 37.5 ± 6.8 | 39.3 ± 2.9 | −2.2 (−3.6 to −0.8) | −1.5 (−2.9 to −0.2) | −1.5(−2.8 to −0.1) | −0.1 (−1.7 to 1.6) |
| Systolic BP, mmHg | 129 ± 16 | 135 ± 13 | −4 (−9 to 0) | −5 (−10 to −1) | −3 (− 8 to 2) | −2 (−8 to 3.5) |
| Diastolic BP, mmHg | 83 ± 11 | 85 ± 9 | −4 (−6 to −1) | −4 (−8 to 1) | −4 (−9 to 0) | 0 (−5 to 6) |
| Resting heart rate, bpm | 66 ± 11 | 66 ± 7 | 4 (1 to 7) | −4 (−6 to −2) | −5 (−7 to −2) | 1 (−2 to 3) |
| HbA1c, mmol/mol | 57 ± 11 | 65 ± 15 | −16 (−25 to −7) | −6 (−10 to −1.4) | −5 (−9 to −0.4) | −1 (−6 to 4) |
| HbA1c, % | 7.4 ± 1.1 | 8.1 ± 1.3 | −1.4 (−2.2 to −0.6) | −0.5 (−0.9 to −0.1) | −0.4 (−0.8 to −0.04) | −0.1 (−0.5 to 0.4) |
| Fasting glucose, mmol/L | 8.6 ± 1 | 9.7 ± 2.7 | −3.2 (−4.4 to −1.9) | −0.5 (−0.9 to −0.1) | −0.7 (−1.2 to −0.3) | 0.3 (−0.3 to 0.8) |
| Fasting insulin, pmol/L | 158 ± 59 | 180 ± 54 | −1 (−26 to 24) | −22 (−47 to 4) | −18 (−44 to 8) | −3 (−34 to 28) |
| Fasting C-peptide, pmol/L | 1296 ± 313 | 1566 ± 484 | 61 (−91 to 213) | −101 (−229 to 27) | −44 (−176 to 88) | −57 (−217 to 103) |
| Δ 6 minute C-peptide, pmol/L | 989 ± 603 | 922 ± 567 | — | — | — | — |
| V̇O2max, L/min | 2.8 ± 0.49 | 2.68 ± 0.52 | −0.13 (−0.29 to 0.43) | 0.39 (0.20 to 0.58) | 0.37 (0.17 to 0.56) | 0.02 (−0.21 to 0.26) |
| V̇O2max, mL/min/kg | 25.9 ± 4.9 | 24.4 ± 2.9 | 0.2 (−1.8 to 2.1) | 4.2 (2.7 to 5.7) | 3.4 (1.9 to 5.0) | 0.8 (−1.1 to 2.6) |
| Variable . | Group . | Intervention . | ETD . | |||
|---|---|---|---|---|---|---|
| Training (n = 15) . | Semaglutide and training (n = 16) . | Semaglutide (n = 12) . | Semaglutide and training (n = 16) . | Training (n = 15) . | ΔSemaglutide and training vs ΔTraining . | |
| . | . | Change (95% CI) . | Change (95% CI) . | Change (95% CI) . | Difference (95% CI) . | |
| Age, years | 56 ± 5.7 | 59 ± 6.2 | — | — | — | — |
| T2D duration, years | 4.2 ± 4 | 5.2 ± 3 | — | — | — | — |
| Body mass, kg | 110.3 ± 21.1 | 111.7 ± 22.3 | −6.7 (−9.9 to −3.5) | −2.2 (−4.2 to −0.2) | −1.2 (−3.3 to 0.9) | −1.0 (−3.5 to 1.5) |
| Height, m | 1.8 ± 0.1 | 1.8 ± 0.1 | — | — | — | — |
| BMI, kg/m2 | 34.6 ± 5.4 | 34.8 ± 4.8 | −2.1 (−3.0 to −1.2) | −0.7 (−1.3 to 0.0) | −0.4 (−1.0 to 0.3) | −0.3 (−1.1 to 0.5) |
| Lean mass, kg | 68.1 ± 11 | 67.3 ± 12.5 | −2.1 (−3.3 to −1.1) | 0.2 (−1.1 to 1.5) | 0.1 (−1.2 to 1.5) | 0.1 (−1.5 to 1.7) |
| Fat mass, kg | 42 ± 13.7 | 43.6 ± 10.9 | −5.2 (−7.8 to −2.5) | −2.1 (−4.0 to −0.2) | −2.4 (−4.3 to −0.5) | 0.3 (−2.0 to 2.7) |
| Visceral fat, kg | 3.4 ± 1.6 | 3.9 ± 1.6 | −0.8 (−1.3 to −0.4) | −0.5 (−0.9 to −0.1) | − 0.3 (−0.8 to 0.1) | −0.2 (−0.7 to 0.4) |
| Body fat percentage, % | 37.5 ± 6.8 | 39.3 ± 2.9 | −2.2 (−3.6 to −0.8) | −1.5 (−2.9 to −0.2) | −1.5(−2.8 to −0.1) | −0.1 (−1.7 to 1.6) |
| Systolic BP, mmHg | 129 ± 16 | 135 ± 13 | −4 (−9 to 0) | −5 (−10 to −1) | −3 (− 8 to 2) | −2 (−8 to 3.5) |
| Diastolic BP, mmHg | 83 ± 11 | 85 ± 9 | −4 (−6 to −1) | −4 (−8 to 1) | −4 (−9 to 0) | 0 (−5 to 6) |
| Resting heart rate, bpm | 66 ± 11 | 66 ± 7 | 4 (1 to 7) | −4 (−6 to −2) | −5 (−7 to −2) | 1 (−2 to 3) |
| HbA1c, mmol/mol | 57 ± 11 | 65 ± 15 | −16 (−25 to −7) | −6 (−10 to −1.4) | −5 (−9 to −0.4) | −1 (−6 to 4) |
| HbA1c, % | 7.4 ± 1.1 | 8.1 ± 1.3 | −1.4 (−2.2 to −0.6) | −0.5 (−0.9 to −0.1) | −0.4 (−0.8 to −0.04) | −0.1 (−0.5 to 0.4) |
| Fasting glucose, mmol/L | 8.6 ± 1 | 9.7 ± 2.7 | −3.2 (−4.4 to −1.9) | −0.5 (−0.9 to −0.1) | −0.7 (−1.2 to −0.3) | 0.3 (−0.3 to 0.8) |
| Fasting insulin, pmol/L | 158 ± 59 | 180 ± 54 | −1 (−26 to 24) | −22 (−47 to 4) | −18 (−44 to 8) | −3 (−34 to 28) |
| Fasting C-peptide, pmol/L | 1296 ± 313 | 1566 ± 484 | 61 (−91 to 213) | −101 (−229 to 27) | −44 (−176 to 88) | −57 (−217 to 103) |
| Δ 6 minute C-peptide, pmol/L | 989 ± 603 | 922 ± 567 | — | — | — | — |
| V̇O2max, L/min | 2.8 ± 0.49 | 2.68 ± 0.52 | −0.13 (−0.29 to 0.43) | 0.39 (0.20 to 0.58) | 0.37 (0.17 to 0.56) | 0.02 (−0.21 to 0.26) |
| V̇O2max, mL/min/kg | 25.9 ± 4.9 | 24.4 ± 2.9 | 0.2 (−1.8 to 2.1) | 4.2 (2.7 to 5.7) | 3.4 (1.9 to 5.0) | 0.8 (−1.1 to 2.6) |
Thirty-one participants with type 2 diabetes underwent randomization to either 20 weeks of semaglutide treatment (0.5-1.0 mg) followed by 12 weeks of semaglutide and aerobic training (n = 16) or directly to 12 weeks of aerobic training (n = 15). Change with semaglutide alone (20 weeks) was assessed in a subgroup (n = 12), and all subjects were assessed before and after training with and without concomitant semaglutide treatment. Data are presented as means ± SD, and changes with each intervention are reported as mean delta values and 95% CI. The within-group effects of training and combined semaglutide and training were analyzed using repeated measures 2-way ANOVA or mixed effects model approach. ETD denotes the difference in response to training in between the 2 groups and was calculated with a 2-sided unpaired t-test and reported as the response to training alone subtracted from the response to training in combination with semaglutide with 95% CI. Δ 6 minutes C-peptide is the increase in C-peptide concentration 6 minutes after administration of 1.0 mg of glucagon intravenously, performed at the screening visits. Changes in glycemic control and body composition are also shown in Fig. 2. To convert plasma insulin to µU/L, divide by 6.0.
Abbreviations: ANOVA< analysis of variance; BMI, body mass index; BP, blood pressure; ETD, estimated treatment difference; HbA1c, glycated hemoglobin; T2D, type 2 diabetes; V̇O2max, maximal oxygen uptake.
| Variable . | Group . | Intervention . | ETD . | |||
|---|---|---|---|---|---|---|
| Training (n = 15) . | Semaglutide and training (n = 16) . | Semaglutide (n = 12) . | Semaglutide and training (n = 16) . | Training (n = 15) . | ΔSemaglutide and training vs ΔTraining . | |
| . | . | Change (95% CI) . | Change (95% CI) . | Change (95% CI) . | Difference (95% CI) . | |
| Age, years | 56 ± 5.7 | 59 ± 6.2 | — | — | — | — |
| T2D duration, years | 4.2 ± 4 | 5.2 ± 3 | — | — | — | — |
| Body mass, kg | 110.3 ± 21.1 | 111.7 ± 22.3 | −6.7 (−9.9 to −3.5) | −2.2 (−4.2 to −0.2) | −1.2 (−3.3 to 0.9) | −1.0 (−3.5 to 1.5) |
| Height, m | 1.8 ± 0.1 | 1.8 ± 0.1 | — | — | — | — |
| BMI, kg/m2 | 34.6 ± 5.4 | 34.8 ± 4.8 | −2.1 (−3.0 to −1.2) | −0.7 (−1.3 to 0.0) | −0.4 (−1.0 to 0.3) | −0.3 (−1.1 to 0.5) |
| Lean mass, kg | 68.1 ± 11 | 67.3 ± 12.5 | −2.1 (−3.3 to −1.1) | 0.2 (−1.1 to 1.5) | 0.1 (−1.2 to 1.5) | 0.1 (−1.5 to 1.7) |
| Fat mass, kg | 42 ± 13.7 | 43.6 ± 10.9 | −5.2 (−7.8 to −2.5) | −2.1 (−4.0 to −0.2) | −2.4 (−4.3 to −0.5) | 0.3 (−2.0 to 2.7) |
| Visceral fat, kg | 3.4 ± 1.6 | 3.9 ± 1.6 | −0.8 (−1.3 to −0.4) | −0.5 (−0.9 to −0.1) | − 0.3 (−0.8 to 0.1) | −0.2 (−0.7 to 0.4) |
| Body fat percentage, % | 37.5 ± 6.8 | 39.3 ± 2.9 | −2.2 (−3.6 to −0.8) | −1.5 (−2.9 to −0.2) | −1.5(−2.8 to −0.1) | −0.1 (−1.7 to 1.6) |
| Systolic BP, mmHg | 129 ± 16 | 135 ± 13 | −4 (−9 to 0) | −5 (−10 to −1) | −3 (− 8 to 2) | −2 (−8 to 3.5) |
| Diastolic BP, mmHg | 83 ± 11 | 85 ± 9 | −4 (−6 to −1) | −4 (−8 to 1) | −4 (−9 to 0) | 0 (−5 to 6) |
| Resting heart rate, bpm | 66 ± 11 | 66 ± 7 | 4 (1 to 7) | −4 (−6 to −2) | −5 (−7 to −2) | 1 (−2 to 3) |
| HbA1c, mmol/mol | 57 ± 11 | 65 ± 15 | −16 (−25 to −7) | −6 (−10 to −1.4) | −5 (−9 to −0.4) | −1 (−6 to 4) |
| HbA1c, % | 7.4 ± 1.1 | 8.1 ± 1.3 | −1.4 (−2.2 to −0.6) | −0.5 (−0.9 to −0.1) | −0.4 (−0.8 to −0.04) | −0.1 (−0.5 to 0.4) |
| Fasting glucose, mmol/L | 8.6 ± 1 | 9.7 ± 2.7 | −3.2 (−4.4 to −1.9) | −0.5 (−0.9 to −0.1) | −0.7 (−1.2 to −0.3) | 0.3 (−0.3 to 0.8) |
| Fasting insulin, pmol/L | 158 ± 59 | 180 ± 54 | −1 (−26 to 24) | −22 (−47 to 4) | −18 (−44 to 8) | −3 (−34 to 28) |
| Fasting C-peptide, pmol/L | 1296 ± 313 | 1566 ± 484 | 61 (−91 to 213) | −101 (−229 to 27) | −44 (−176 to 88) | −57 (−217 to 103) |
| Δ 6 minute C-peptide, pmol/L | 989 ± 603 | 922 ± 567 | — | — | — | — |
| V̇O2max, L/min | 2.8 ± 0.49 | 2.68 ± 0.52 | −0.13 (−0.29 to 0.43) | 0.39 (0.20 to 0.58) | 0.37 (0.17 to 0.56) | 0.02 (−0.21 to 0.26) |
| V̇O2max, mL/min/kg | 25.9 ± 4.9 | 24.4 ± 2.9 | 0.2 (−1.8 to 2.1) | 4.2 (2.7 to 5.7) | 3.4 (1.9 to 5.0) | 0.8 (−1.1 to 2.6) |
| Variable . | Group . | Intervention . | ETD . | |||
|---|---|---|---|---|---|---|
| Training (n = 15) . | Semaglutide and training (n = 16) . | Semaglutide (n = 12) . | Semaglutide and training (n = 16) . | Training (n = 15) . | ΔSemaglutide and training vs ΔTraining . | |
| . | . | Change (95% CI) . | Change (95% CI) . | Change (95% CI) . | Difference (95% CI) . | |
| Age, years | 56 ± 5.7 | 59 ± 6.2 | — | — | — | — |
| T2D duration, years | 4.2 ± 4 | 5.2 ± 3 | — | — | — | — |
| Body mass, kg | 110.3 ± 21.1 | 111.7 ± 22.3 | −6.7 (−9.9 to −3.5) | −2.2 (−4.2 to −0.2) | −1.2 (−3.3 to 0.9) | −1.0 (−3.5 to 1.5) |
| Height, m | 1.8 ± 0.1 | 1.8 ± 0.1 | — | — | — | — |
| BMI, kg/m2 | 34.6 ± 5.4 | 34.8 ± 4.8 | −2.1 (−3.0 to −1.2) | −0.7 (−1.3 to 0.0) | −0.4 (−1.0 to 0.3) | −0.3 (−1.1 to 0.5) |
| Lean mass, kg | 68.1 ± 11 | 67.3 ± 12.5 | −2.1 (−3.3 to −1.1) | 0.2 (−1.1 to 1.5) | 0.1 (−1.2 to 1.5) | 0.1 (−1.5 to 1.7) |
| Fat mass, kg | 42 ± 13.7 | 43.6 ± 10.9 | −5.2 (−7.8 to −2.5) | −2.1 (−4.0 to −0.2) | −2.4 (−4.3 to −0.5) | 0.3 (−2.0 to 2.7) |
| Visceral fat, kg | 3.4 ± 1.6 | 3.9 ± 1.6 | −0.8 (−1.3 to −0.4) | −0.5 (−0.9 to −0.1) | − 0.3 (−0.8 to 0.1) | −0.2 (−0.7 to 0.4) |
| Body fat percentage, % | 37.5 ± 6.8 | 39.3 ± 2.9 | −2.2 (−3.6 to −0.8) | −1.5 (−2.9 to −0.2) | −1.5(−2.8 to −0.1) | −0.1 (−1.7 to 1.6) |
| Systolic BP, mmHg | 129 ± 16 | 135 ± 13 | −4 (−9 to 0) | −5 (−10 to −1) | −3 (− 8 to 2) | −2 (−8 to 3.5) |
| Diastolic BP, mmHg | 83 ± 11 | 85 ± 9 | −4 (−6 to −1) | −4 (−8 to 1) | −4 (−9 to 0) | 0 (−5 to 6) |
| Resting heart rate, bpm | 66 ± 11 | 66 ± 7 | 4 (1 to 7) | −4 (−6 to −2) | −5 (−7 to −2) | 1 (−2 to 3) |
| HbA1c, mmol/mol | 57 ± 11 | 65 ± 15 | −16 (−25 to −7) | −6 (−10 to −1.4) | −5 (−9 to −0.4) | −1 (−6 to 4) |
| HbA1c, % | 7.4 ± 1.1 | 8.1 ± 1.3 | −1.4 (−2.2 to −0.6) | −0.5 (−0.9 to −0.1) | −0.4 (−0.8 to −0.04) | −0.1 (−0.5 to 0.4) |
| Fasting glucose, mmol/L | 8.6 ± 1 | 9.7 ± 2.7 | −3.2 (−4.4 to −1.9) | −0.5 (−0.9 to −0.1) | −0.7 (−1.2 to −0.3) | 0.3 (−0.3 to 0.8) |
| Fasting insulin, pmol/L | 158 ± 59 | 180 ± 54 | −1 (−26 to 24) | −22 (−47 to 4) | −18 (−44 to 8) | −3 (−34 to 28) |
| Fasting C-peptide, pmol/L | 1296 ± 313 | 1566 ± 484 | 61 (−91 to 213) | −101 (−229 to 27) | −44 (−176 to 88) | −57 (−217 to 103) |
| Δ 6 minute C-peptide, pmol/L | 989 ± 603 | 922 ± 567 | — | — | — | — |
| V̇O2max, L/min | 2.8 ± 0.49 | 2.68 ± 0.52 | −0.13 (−0.29 to 0.43) | 0.39 (0.20 to 0.58) | 0.37 (0.17 to 0.56) | 0.02 (−0.21 to 0.26) |
| V̇O2max, mL/min/kg | 25.9 ± 4.9 | 24.4 ± 2.9 | 0.2 (−1.8 to 2.1) | 4.2 (2.7 to 5.7) | 3.4 (1.9 to 5.0) | 0.8 (−1.1 to 2.6) |
Thirty-one participants with type 2 diabetes underwent randomization to either 20 weeks of semaglutide treatment (0.5-1.0 mg) followed by 12 weeks of semaglutide and aerobic training (n = 16) or directly to 12 weeks of aerobic training (n = 15). Change with semaglutide alone (20 weeks) was assessed in a subgroup (n = 12), and all subjects were assessed before and after training with and without concomitant semaglutide treatment. Data are presented as means ± SD, and changes with each intervention are reported as mean delta values and 95% CI. The within-group effects of training and combined semaglutide and training were analyzed using repeated measures 2-way ANOVA or mixed effects model approach. ETD denotes the difference in response to training in between the 2 groups and was calculated with a 2-sided unpaired t-test and reported as the response to training alone subtracted from the response to training in combination with semaglutide with 95% CI. Δ 6 minutes C-peptide is the increase in C-peptide concentration 6 minutes after administration of 1.0 mg of glucagon intravenously, performed at the screening visits. Changes in glycemic control and body composition are also shown in Fig. 2. To convert plasma insulin to µU/L, divide by 6.0.
Abbreviations: ANOVA< analysis of variance; BMI, body mass index; BP, blood pressure; ETD, estimated treatment difference; HbA1c, glycated hemoglobin; T2D, type 2 diabetes; V̇O2max, maximal oxygen uptake.
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