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ASCEND PLUS is testing a medication called oral semaglutide. (‘Oral’ means that it is taken by mouth.)

This medication is approved for use in the UK as a treatment for type 2 diabetes and helps to improve blood sugar control. At higher doses it also used for weight loss.

Semaglutide is similar to a hormone that occurs in the body called glucagon-like peptide-1 (GLP-1). It acts like the hormone to:

  • stimulate the release of insulin by the pancreas after eating, even before blood sugars start to rise
  • help the liver make less sugar (glucose) by inhibiting the release of the hormone glucagon by the pancreas (glucagon causes the liver to release its stored sugar into the bloodstream)
  • reduce the speed at which the stomach empties after eating. This slows sugar absorption into the bloodstream from the food.

These effects all help to control blood sugar in people with type 2 diabetes.

GLP-1 also has other actions in the body. Medications, such as oral semaglutide, which work like the hormone GLP-1 are called ‘GLP-1 receptor agonists’ (or ‘GLP-1-RAs). They help to protect against heart and circulatory problems in people who already have these conditions. Scientists don’t know how these medications help to protect the body’s circulatory system.