Core Viewpoint - The article discusses the increasing popularity and sales of Semaglutide in the Chinese market among obesity patients, highlighting the rapid development of domestic generic versions of the drug. Semaglutide is a novel weight loss and blood sugar regulation medication that mimics the natural hormone GLP-1, but it also has contraindications and side effects that require health assessments before use [4]. Group 1: Health Assessments Before Using Semaglutide - Patients with a family history of thyroid disease or a history of pancreatitis are generally advised against using Semaglutide. Thyroid function tests, including thyroid ultrasound, are recommended to assess the risk of thyroid C-cell tumors [4]. - Individuals with a history of Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2) should inform their healthcare provider, as these conditions may contraindicate the use of Semaglutide [5]. - Continuous monitoring for acute pancreatitis is essential, including abdominal ultrasounds or CT scans and blood lipid tests to assess triglyceride levels, as high triglycerides are a significant risk factor for pancreatitis [7]. Group 2: Additional Health Checks - Kidney function tests are necessary before starting Semaglutide treatment, as the drug is primarily excreted through the kidneys. Regular monitoring of kidney function is also required during treatment [7]. - Cardiac function assessments are crucial before initiating Semaglutide therapy to ensure patient suitability and monitor potential cardiovascular risks. This may include ECGs, biochemical blood tests, echocardiograms, and Holter monitoring if necessary [8]. Group 3: Overview of GLP-1 Drugs - GLP-1 (Glucagon-Like Peptide-1) is a hormone produced by intestinal L-cells and is classified as an incretin. GLP-1 receptor agonists are a new class of hypoglycemic drugs that enhance insulin secretion in a glucose-dependent manner, suppress glucagon secretion, and delay gastric emptying, thereby reducing food intake and achieving blood sugar reduction and weight loss [19].

Core Insights - The article highlights the discovery of a large quantity of illegal weight loss drugs containing methamphetamine, a controlled substance, by customs officials in Hefei [2][4]. Group 1: Regulatory Issues - Methamphetamine is classified as a first-class psychoactive drug in China, known for its addictive properties and is the active ingredient in ice drugs [4]. - According to the Drug Administration Law of the People's Republic of China, the import and export of narcotic drugs and certain psychoactive substances require permits issued by the State Drug Administration [4]. Group 2: Industry Context - The article emphasizes the growing concern over the illegal trade of weight loss drugs, particularly those containing harmful substances, which poses risks to public health [2][4]. - The GLP-1 drug class is mentioned as a new category of weight loss and diabetes management medications, which work by enhancing insulin secretion and suppressing appetite [11].

Core Viewpoint - The article emphasizes the importance of adhering to the recommended administration guidelines for oral semaglutide to achieve optimal therapeutic effects in weight loss and blood sugar control [2][13]. Administration Guidelines - The recommended way to take oral semaglutide is to consume it with no more than 4 ounces (approximately 120 milliliters) of water before breakfast, ensuring at least a 30-minute interval before eating or drinking anything else [2]. - Taking the medication before any meal or after any meal is less effective due to shorter fasting periods, which can lead to lower plasma concentrations of semaglutide [3]. - If a person only eats lunch and dinner, taking the medication before lunch is acceptable; similarly, if only breakfast and dinner are consumed, taking it before dinner is also permissible [4]. - Taking the medication after meals is not recommended as it significantly diminishes its effectiveness [5]. Timing Considerations - Taking the medication before bedtime is contingent on the fasting duration; if dinner is skipped, it can be taken before sleep, but it is not advisable if dinner is consumed due to insufficient fasting time [7][8]. - The amount of water used to take the medication should not exceed 120 mL, as excessive water can hinder the drug's absorption [9]. - It is crucial to wait at least 30 minutes after taking the medication before consuming breakfast or any other oral medications to avoid interference with absorption [10]. Impact of Non-compliance - Occasional deviations from the recommended administration (e.g., forgetting to take the medication or taking it with too much water) generally have a minimal impact on overall efficacy; however, consistent non-compliance can adversely affect therapeutic outcomes [11][12]. Efficacy Comparison - Oral semaglutide (Rybelsus) and injectable semaglutide (Ozempic) have been shown to have comparable efficacy in clinical trials, with similar reductions in A1C levels and weight loss observed in both [14].