Top Studies, Highlights From ADA 2021

This transcript has been edited for clarity.

Akshay B. Jain, MD: Hi. My name is Dr Akshay Jain, and with me is Dr Harpreet Bajaj. Together, we're the columnists of Medscape's Sugar Beat. We are very excited to discuss highlights of the American Diabetes Association 81st Scientific Sessions, especially the clinically relevant points.

The Incretins

Let me start off with the glucagon-like peptide 1 (GLP-1) studies. The SUSTAIN FORTE study, for which Dr Bajaj was one of the coauthors, was a head-to-head comparison of the glycemic-lowering effect of semaglutide 2.0 mg/wk vs 1.0 mg/wk on the background of metformin plus or minus sulfonylurea therapy.

[Among patients with] a baseline A1c of 8.8%, semaglutide 2.0 mg/wk reduced the A1c by 2.2% vs 1.9% with the lower dose of semaglutide. The weight reduction was about 0.93 kg more with the higher dose. In my opinion, the A1c difference, although statistically significant, may not be too clinically relevant from strictly the glycemic control point of view, although the weight reduction was quite significant.

If the 2-mg dose ever comes out on the market, depending on the cost difference between the two doses, it may be worthwhile to consider a different agent to achieve further glycemic control based on the target for our patients.