Dr.ObesityLA said:The dose-response is real but shallow at the top.
That reframing is the part I needed. Adding it to my notes with a link back to this thread.
Clinical perspective, offered as context rather than as advice.
The FLOW trial results on renal function and renal outcomes: semaglutide 1.0mg reduced the composite kidney outcome by 24% (HR 0.76, p=0.0003) in CKD patients with T2DM[1].
The trial was stopped early for efficacy — always a strong signal. GFR decline was 1.16 mL/min/1.73m²/year slower with semaglutide. This positions GLP-1 agonists alongside SGLT2 inhibitors as pillars of cardiorenal protection in T2DM.
Dr.SportsMedIN said:The mechanism that matters here is not stomach emptying, it is central.
I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.
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View Resultssteve_okc said:FLOW is the relevant trial and it reported a meaningful reduction in kidney-disease progression and related death in people with type 2 diabetes and…
Kidney function labs on renal function — good news for anyone concerned about renal effects:
| Marker | Baseline | Month 6 | Ref Range |
|---|---|---|---|
| eGFR | 87 | 94 | >60 |
| Creatinine | 1.1 | 1.0 | 0.7-1.3 |
| BUN | 23 | 16 | 7-20 |
| UACR | 72 | 25 | <30 |
The FLOW trial demonstrated renal protective effects of semaglutide. My nephrologist is encouraged by the UACR improvement especially.
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