Semaglutide is a prescription medication, given as a weekly injection or daily tablet, used for weight loss and blood-sugar control. Large trials show substantial weight loss and fewer heart attacks, strokes and deaths in people with heart disease, kidney disease or diabetes. Trade-offs include digestive side effects and some muscle and bone loss; gains fade once treatment stops, and evidence in lean, healthy adults is nearly absent. (Full Review)
| Marker | Target | Why |
|---|---|---|
| HbA1c | 4.0–5.6% | Expected change: falls |
| Fasting glucose | 70–99 mg/dL | Expected change: falls; safety check with insulin or sulfonylureas |
| Serum creatinine and eGFR | Creatinine 0.6–1.2 mg/dL (men), 0.5–1.1 mg/dL (women) | Safety check: dehydration-related kidney injury |
| Urine albumin-to-creatinine ratio | Below 30 mg/g | Expected change: falls in kidney disease |
| ALT | 7–56 U/L | Expected change: falls with fatty liver |
| Lipase | 13–60 U/L | Safety check: pancreatitis, only with severe abdominal pain |
| hs-CRP | No established target; track change from own baseline | Expected change: falls |
| TSH (if on levothyroxine) | 0.4–4.0 mIU/L | Safety check: thyroid replacement dose |
| Ferritin | 30–400 ng/mL (men), 15–150 ng/mL (women) | Safety check: iron shortfall from lower intake or absorption |
| Vitamin B12 | 200–900 pg/mL | Safety check: shortfall from lower intake |
| Lean mass (DEXA) | No established target; track lean share of weight lost | Safety check: lean-mass loss |
| Body weight, waist circumference and blood pressure | Track change from own baseline | Expected change: falls |
| Resting heart rate | Track change from own baseline | Safety check: sustained rise |
Cadence: Baseline; weight, heart rate, blood pressure and side effects at each 4-week dose step; laboratory tests at 3 months, then every 6–12 months; body-composition scan every 6–12 months; kidney tests sooner during vomiting or diarrhea