司美格鲁肽降糖这么猛，正常人减重使用为何不会低血糖？

Core Viewpoint - Semaglutide, a GLP-1 receptor agonist, effectively lowers blood sugar levels and has additional benefits in weight loss and cardiovascular risk reduction, making it a comprehensive treatment option for type 2 diabetes patients [2][4]. Mechanism of Action - Semaglutide mimics the natural GLP-1 hormone, promoting insulin secretion when blood sugar levels are high and suppressing glucagon release when blood sugar is normal, thus maintaining glucose balance [2][4]. - It reduces appetite through three main mechanisms: central nervous system effects, gastrointestinal effects, and changes in food preferences [5][9][11]. Central Nervous System Effects - Semaglutide acts on the hypothalamus, a key area for appetite regulation, activating GLP-1 receptors to reduce hunger and appetite [5][7]. Gastrointestinal Effects - It slows gastric emptying, increasing feelings of fullness and reducing food intake, which also helps in controlling postprandial blood sugar levels [9][11]. Changes in Food Preferences - Clinical studies indicate that semaglutide reduces the preference and intake of high-fat, fried, or sweet foods, likely due to its influence on the brain's appetite regulation centers [11]. Weight Loss Data - In the PIONEER PLUS study, participants taking 50mg and 25mg doses of oral semaglutide lost an average of 9.2kg (9.54%) and 7.0kg (7.26%) respectively over 68 weeks [14]. - The OASIS 1 study showed that participants in the 50mg group lost an average of 18.34kg (17.4%) [14]. - The OASIS 4 study reported a 13.6% (14.4kg) weight loss over 64 weeks, with potential for up to 16.6% (17.6kg) if all participants completed the treatment [15].