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Kessler says

Also, it might be ineffective for substantial HGH stimulation in less sensitive individuals, such as those with obesity or diabetes.

Data resource profile: the National Health Information Database of the National Health Insurance Service in South Korea

Semma (Semaglutide) Oral was effective in patients with type 2 diabetes and moderate renal impairment, potentially providing a new treatment option for this population." Semma (Semaglutide) Oral provides effective glucose lowering and body weight loss, with low risk of hypoglycemia.12

Because it only works when glucose is elevated, the risk of hypoglycemia was low (except if combined with a sulfonylurea that independently can cause low sugars) ( [2] ) ( [96] )