Japanese doctors's resistance to oral semaglutide decreased after prescribing, with 95% of patients adherent | Research

The takeaway

After prescribing oral semaglutide, 44.6% of Japanese physicians reported ≥80% patient adherence (vs 17.2% expected), 56% initial physician resistance decreased, and 95.2% of patients missed ≤1 dose/week despite dosing requirements.

95.2% adherent
Nearly all Japanese patients on oral semaglutide missed ≤1 dose/week, far exceeding physician expectations and proving dosing requirements are manageable

What the researchers found

Pre-prescribing: 17.2% expected ≥80% adherence, 56.4% resistant. Post-prescribing: 44.6% reported ≥80% adherence, 95.2% of patients missed ≤1 dose/week. Physician resistance decreased in 44.2%. 330 physicians + 412 patients surveyed.

Why it matters

Physician hesitation about oral semaglutide's dosing complexity has limited prescribing. This survey proves real-world adherence far exceeds expectations, potentially removing a key barrier to oral GLP-1 drug adoption.

How the study worked

Web-based survey across 330 treating physicians and 412 T2DM patients. Baseline and post-initiation perceptions of oral semaglutide adherence and dosing requirements.

What this study cannot tell us

Japanese population—cultural adherence factors may differ. Web-based survey with potential selection bias. Self-reported adherence may overestimate. Oral semaglutide specific formulation requirements.

How to read the evidence

Web-based survey with 742 participants. Good real-world adherence data but subject to self-report and selection biases.

When this study was published

Published in 2025.

The bigger picture

Oral GLP-1 drugs remove the injection barrier for millions of patients. This Japanese survey adds to evidence that dosing complexity—the main concern—is manageable in real clinical practice.

Questions still open

Would similar adherence be seen in Western populations?
Does the dosing routine become easier over time?
How does oral semaglutide adherence compare to injectable semaglutide?

Common questions

Is it hard to take oral semaglutide correctly?

Despite initial concerns about the dosing requirements (empty stomach, limited water, 30-minute wait before eating), 95.2% of Japanese patients managed to miss ≤1 dose per week. Most patients found it easier than expected, and many physicians who were initially resistant changed their minds after seeing real-world adherence.

Why were doctors hesitant about oral semaglutide?

Over half (56.4%) of Japanese physicians were initially resistant because of the strict dosing requirements. However, after prescribing it, 44.2% reported their resistance decreased. The key finding: only 17.2% expected good adherence, but 44.6% actually achieved it—real-world performance exceeded pessimistic expectations.

Read the original research

Perceptions and Attitudes Toward Oral Semaglutide Among Japanese Physicians and Individuals with Type 2 Diabetes: A Web-Based Survey.

Diabetes therapy : research, treatment and education of diabetes and related disorders, 16(7), 1479-1495

View on PubMed ↗Publisher’s paper ↗

Citation

Suzuki, Ryo; Chand, Krishant; Taguchi, Yuu. (2025). Perceptions and Attitudes Toward Oral Semaglutide Among Japanese Physicians and Individuals with Type 2 Diabetes: A Web-Based Survey.. Diabetes therapy : research, treatment and education of diabetes and related disorders, 16(7), 1479-1495. https://doi.org/10.1007/s13300-025-01739-2