Semaglutide Guidelines Based on BMI May Exclude At-Risk Indians in India The SELECT trial, led by A. Michael Lincoff and published in The New England Journal of Medicine in 2023, demonstrated that once-weekly semaglutide significantly reduced major cardiovascular events by 20% in adults with a body mass index (BMI) of 27 or higher and pre-existing cardiovascular disease but without diabetes. The study enrolled 17,604 participants and tracked their outcomes over nearly 40 months. These findings highlight the drug’s potential as a therapeutic option for specific patient groups. However, experts warn that applying the BMI threshold used in the trial could inadvertently exclude a significant portion of high-risk patients in India, particularly those who do not meet the global criteria but still face elevated cardiovascular risks. Aditi Kantipuly, a physician and resident in preventive medicine and public health at McGill University, as well as a visiting scholar at the University of New Mexico, raised concerns about the implications of using the same BMI thresholds for semaglutide eligibility in India. She emphasized that the global BMI cutoff of 27 may not accurately reflect the health risks faced by Indian patients. In many cases, individuals in India with lower BMI values could still have metabolic and cardiovascular conditions that place them at risk for heart disease. The trial’s exclusion of patients without diabetes further complicates its applicability in regions like India, where diabetes prevalence is high and often coexists with cardiovascular disease. The trial’s focus on patients without diabetes is significant because it underscores the drug’s potential for a broader population.#india #select_trial #a_michael_lincoff #new_england_journal_of_medicine #aditi_kantipuly
