Semaglutide use and outcomes in chronic plantar heel pain

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Association of semaglutide use with outcomes in chronic plantar heel pain: a prospective observational cohort and a pilot interventional study
Yang, Fana et al
International Journal of Surgery ():10.1097/JS9.0000000000003156, August 08, 2025.

 

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Semaglutide


Overview

• Class: Glucagon-like peptide-1 (GLP-1) receptor agonist.
• Origin: Synthetic analog of human GLP-1 (modifications for longer half-life).
• Administration: Subcutaneous injection (weekly) or oral tablet (daily).
• Brand Names: Ozempic®, Wegovy®, Rybelsus®.

Mechanism of Action

• Mimics GLP-1, a hormone that:
  • Stimulates glucose-dependent insulin secretion.
  • Suppresses glucagon release.
  • Delays gastric emptying.
  • Reduces appetite via CNS pathways.
• Results in lower blood glucose and weight reduction.

Indications

• Type 2 diabetes mellitus – improves glycemic control.
• Chronic weight management (obesity or overweight with comorbidities).
• Cardiovascular risk reduction in adults with type 2 diabetes + established CV disease.

Pharmacokinetics

• Half-life: ~1 week.
• Metabolism: Proteolytic cleavage + beta-oxidation.
• Excretion: Urinary and fecal routes.

Efficacy

• Significant HbA1c reduction (~1–1.5%).
• Clinically relevant weight loss (up to ~15% body weight in some trials).
• Cardiovascular outcome trials show reduced risk of major adverse cardiac events (MACE).

Adverse Effects

• Common: Nausea, vomiting, diarrhea, constipation, abdominal pain.
• Serious: Pancreatitis, gallbladder disease, acute kidney injury.
• Rare but notable: Risk of medullary thyroid carcinoma (in rodents; boxed warning).

Contraindications

• Personal/family history of medullary thyroid carcinoma (MTC).
• Multiple endocrine neoplasia syndrome type 2 (MEN2).
• Hypersensitivity to semaglutide or excipients.

Drug Interactions

• Delayed gastric emptying may affect absorption of oral drugs.
• Caution with insulin or sulfonylureas (risk of hypoglycemia).

Special Notes

• Not for type 1 diabetes or diabetic ketoacidosis.
• Gradual dose escalation to reduce GI side effects.
• Lifestyle changes recommended alongside therapy.
• High cost; insurance coverage varies.