Higher baseline vitamin D levels were associated with greater improvements in glycemic control and BMI after 12 months of semaglutide treatment in adults with type 2 diabetes, supporting further study of whether vitamin D supplementation could enhance treatment response.
Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is widely used in type 2 diabetes because of its effects on glycemic control and body weight, while cardiovascular benefits have also been demonstrated in high-risk populations. However, patients vary in the magnitude of their metabolic response, raising interest in factors that might help explain this variation.
At ESC Congress 2026, Prof. Rami Abu Fanne (Hillel Yaffe Medical Center and Hadassah Medical Center, The Hebrew University of Jerusalem) presented an analysis exploring whether baseline vitamin D levels were associated with metabolic response to semaglutide in people with type 2 diabetes. The study included 5,300 adults and found that higher baseline vitamin D levels were associated with greater improvements in glycemic control and BMI after 12 months of treatment, although no association was observed with lipid outcomes. Dr Abu Fanne spoke to touchCARDIO about the findings and the questions they raise for future research.
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What were the key findings from your study?
We wanted to understand whether baseline vitamin D levels might influence the metabolic effects of semaglutide in patients with type 2 diabetes, particularly in terms of glycemic control, weight, and lipid profile.
We divided patients according to baseline vitamin D levels: below 15 ng/mL, between 15 and 25 ng/mL, and above 25 ng/mL. What we found was that higher vitamin D levels were associated with better glycemic control and greater reductions in BMI after semaglutide treatment. However, we did not see the same relationship with lipid profile, where the effect appeared neutral.
The important question now is whether vitamin D is simply a biomarker associated with better response, or whether supplementation could actually enhance the effects of semaglutide. That will require prospective studies.
How did baseline vitamin D levels influence the observed outcomes?
Vitamin D levels were relatively low across the cohort, with a median value of around 19 ng/mL.
When we compared patients with vitamin D levels below 15 ng/mL with those who had higher levels, we found a significant association between higher vitamin D and better outcomes with semaglutide in terms of both weight control and glycemic control.
This suggests that baseline vitamin D status may be one factor associated with variation in how patients respond to treatment.
What might explain this relationship?
Vitamin D has previously been associated with metabolic regulation, including both glycemic control and body weight.
Our findings suggest that vitamin D may act as a cofactor in this setting, but we cannot establish the mechanism from this study. We need further research to understand whether vitamin D itself contributes to the improved response or whether it reflects other metabolic or clinical characteristics.
Do these findings have implications for clinical practice?
Potentially, but we need prospective studies before changing clinical practice.
The important next step is to investigate whether correcting low vitamin D levels through supplementation can improve the response to semaglutide. If prospective trials show that supplementation leads to better glycemic or weight outcomes, vitamin D could become a relatively simple factor to consider alongside semaglutide treatment.
At this stage, however, our findings demonstrate an association and provide a rationale for further study rather than evidence that vitamin D supplementation should routinely be used to enhance semaglutide response.
Abstract: Abu Fanne R, Israeli A. Efficacy of Semaglutide in glycemic control, weight loss, and improving lipid profile – the role of baseline vitamin D levels. Presented at ESC Congress 2026, 28-31 August 2026, Munich, Germany.
Cite: Could vitamin D status influence response to semaglutide in type 2 diabetes? touchCARDIO. September 2, 2026.
Disclosure: This content has been developed independently by Touch Medical Media for touchCARDIO. No funding was received in the publication of this article. Thank you to Dr Rami Abu Fanne for sharing his expert insights. Dr Rami Abu Fanne has nothing to disclose in relation to this content.
Editor: Caroline Markham, Head of Partnerships
