甲状腺结节患者，使用司美格鲁肽等GLP-1RA药物的指南

Core Viewpoint - The article discusses the efficacy of oral semaglutide (GLP-1 receptor agonist) in managing type 2 diabetes and supporting weight loss, highlighting its potential to provide more options for weight management medications [8][10]. Group 1: Study Overview - The PIONEER REAL study conducted in the Netherlands evaluated the effects of oral semaglutide on 187 participants with type 2 diabetes, showing significant weight loss of 5.8 kg and a reduction in HbA1c levels from 8.6% to 7.3% [10][11]. - The study included participants aged 18 and older, with an average age of 58 years, and a majority being male (54%) and white (88%) [10]. - Participants reported high treatment satisfaction, with 79% continuing the treatment by the end of the study [11]. Group 2: Treatment Details - Participants were administered oral semaglutide daily for a treatment duration of 34-44 weeks, with 98% receiving a dose of 3 mg and 2% receiving 7 mg [10]. - The average number of diabetes medications used by participants increased from 1.6 at baseline to 2.4 by the end of the study [10]. - The study found no significant difference in the effects of semaglutide between patients treated by diabetes specialists and non-specialists [11]. Group 3: Mechanism of Action - Oral semaglutide utilizes a small molecule absorption enhancer (SNAC) to facilitate absorption in the stomach, ensuring it achieves similar glucose-lowering effects as injectable forms [12]. - This innovative mechanism addresses the challenges of oral peptide medications, providing a viable alternative for patients who prefer oral administration over injections [12][14]. Group 4: Market Implications - The introduction of oral semaglutide is expected to change the landscape of weight management medications, offering more choices for patients who may be averse to injections [14][15]. - The focus is on personalized treatment options that cater to individual patient needs and goals, enhancing the overall treatment experience [15].