Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs

Popoviciu, Mihaela Simona; Reurean-Pintilei, Delia; Salmen, Teodor; Rus, Marius; Ferician, Anca; Sava, Cristian; Ardelean, Adriana Ioana; Moroianu, Lavinia-Alexandra; Pantea Stoian, Anca

doi:10.3390/biomedicines13092174

Open AccessArticle

Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs

by

Mihaela Simona Popoviciu

^1,2,*,

Delia Reurean-Pintilei

³

,

Teodor Salmen

^4,5

,

Marius Rus

²

,

Anca Ferician

^1,2,

Cristian Sava

^6,7

,

Adriana Ioana Ardelean

^8,9,

Lavinia-Alexandra Moroianu

¹⁰

and

Anca Pantea Stoian

¹¹

¹

Department of Diabetes, Nutrition and Metabolic Diseases-Clinical Section Internal Medicine I, Bihor County Emergency Clinical Hospital, 410169 Oradea, Romania

²

Department of Clinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania

³

Department of Medical-Surgical and Complementary Sciences, Faculty of Medicine and Biological Sciences, “Ștefan cel Mare” University, 720229 Suceava, Romania

⁴

Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania

⁵

Pitesti Emergency County Hospital, 110283 Pitesti, Romania

⁶

Department of Pediatrics, Emergency County Hospital Bihor, 410167 Oradea, Romania

⁷

Department of Medical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania

⁸

Department of Preclinical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania

⁹

Department of Cardiology, Clinical Emergency County Hospital Oradea, 410169 Oradea, Romania

¹⁰

Pharmaceutical Sciences Department, Dunarea de jos University, 800201 Galati, Romania

¹¹

Diabetes, Nutrition and Metabolic Diseases Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania

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Biomedicines 2025, 13(9), 2174; https://doi.org/10.3390/biomedicines13092174

Submission received: 27 July 2025 / Revised: 29 August 2025 / Accepted: 30 August 2025 / Published: 5 September 2025

(This article belongs to the Special Issue Diabetes Mellitus: Pharmacological Innovations and Related Therapeutic Benefits)

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Abstract

Background/Objectives: Obesity and type 2 diabetes mellitus (T2DM) have a continuously increasing prevalence and often co-exist, exacerbating cardiometabolic risk. GLP-1 receptor agonists (GLP-1 RAs) are recommended as first-line therapy for patients with T2DM and excess weight, particularly when cardiovascular risk is present. This study assessed the real-world effectiveness of available GLP-1 RAs in Romania on glycemic control, body weight reduction (BWR), and waist circumference (WC) in T2DM patients with excess weight. Methods: A prospective observational study was conducted on 311 adults with T2DM (glycated hemoglobin (HbA1c) > 7.2%, body mass index (BMI) ≥ 25 kg/m²). Patients received exenatide, semaglutide (either oral or injectable), or dulaglutide and were monitored for a period of 6 months. Parameters assessed included HbA1c, body weight, BMI, and WC. Results: All treatments significantly improved the patients’ HbA1c, BMI, and WC (p < 0.05). Dulaglutide had the most significant impact on HbA1c (−6.69 ± 0.91%), while injectable semaglutide led to the most notable BWR (−4.60 ± 2.74 kg) and WC reduction, especially among male patients. No significant differences in treatment effect were observed concerning the patient’s age, gender, or T2DM duration. Conclusions: In real-world clinical practice, GLP-1 RAs provide significant metabolic benefits and should be considered as part of individualized treatment strategies for T2DM patients who are overweight or obese.

Keywords: Type 2 diabetes mellitus; obesity; GLP-1 receptor agonists; semaglutide; exenatide; dulaglutide; glycemic control; real-world evidence

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MDPI and ACS Style

Popoviciu, M.S.; Reurean-Pintilei, D.; Salmen, T.; Rus, M.; Ferician, A.; Sava, C.; Ardelean, A.I.; Moroianu, L.-A.; Pantea Stoian, A. Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs. Biomedicines 2025, 13, 2174. https://doi.org/10.3390/biomedicines13092174

AMA Style

Popoviciu MS, Reurean-Pintilei D, Salmen T, Rus M, Ferician A, Sava C, Ardelean AI, Moroianu L-A, Pantea Stoian A. Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs. Biomedicines. 2025; 13(9):2174. https://doi.org/10.3390/biomedicines13092174

Chicago/Turabian Style

Popoviciu, Mihaela Simona, Delia Reurean-Pintilei, Teodor Salmen, Marius Rus, Anca Ferician, Cristian Sava, Adriana Ioana Ardelean, Lavinia-Alexandra Moroianu, and Anca Pantea Stoian. 2025. "Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs" Biomedicines 13, no. 9: 2174. https://doi.org/10.3390/biomedicines13092174

APA Style

Popoviciu, M. S., Reurean-Pintilei, D., Salmen, T., Rus, M., Ferician, A., Sava, C., Ardelean, A. I., Moroianu, L.-A., & Pantea Stoian, A. (2025). Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs. Biomedicines, 13(9), 2174. https://doi.org/10.3390/biomedicines13092174

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Translating Guidelines into Practice: A Prospective Real-World Study of a Romanian Cohort Treated with GLP-1 RAs

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