Efficacy and Safety of Once‐Weekly Semaglutide 2.0 mg as an Add‐On to Dose‐Reduced Insulin Glargine versus Dose‐Titrated Insulin Glargine in People With Type 2 Diabetes and Overweight ( SUSTAIN OPTIMIZE )
Primary result · Change in HbA1cResult — go to the resultEstimated treatment difference −0.74 % 95% CI −0.90 to −0.59Authors' conclusion
Once-weekly subcutaneous semaglutide 2.0 mg as add-on to dose-reduced IGlar achieved superior reductions in HbA1c, BW, and daily insulin dose in people with T2D and overweight, while reducing their risk for severe hypoglycaemia compared to dose-titrated IGlar alone.
Study context
- Population
- Adults with T2D, overweight (BMI ≥ 25 kg/m²), on basal insulin ≤ 40 units/dayrandomised 1:1
- Participants
- 573 adults
- Comparison
- Once-weekly semaglutide 2.0 mg add-on to dose-reduced insulin glargine vs dose-titrated insulin glargine
- Primary endpoint
- Change in HbA1c (non-inferiority approach)
- Follow-up
- 40 weeks
Methodological detailsphase 3b, open-label, non-inferiority, 40-week
- Phase 3b
- Open-label
- Non-inferiority
- 40-week
Primary result
Change in HbA1c
Estimated treatment difference
−0.74 %
95% CI −0.90 to −0.59
P < 0.0001
Sema+IGlarreducedvs IGlartitrated
estimated treatment difference −0.74 % (95% CI −0.90 to −0.59); P < 0.0001
As reported in the abstract
Secondary outcomes
| Outcome | Estimated treatment difference (kg) (95% CI) | P value | |
|---|---|---|---|
| BW change | −8.5 (−9.5 to −7.4) | P < 0.0001 | |
| −10−505Difference, kg (linear scale) |
| Outcome | Estimated treatment difference (%) (95% CI) | P value | |
|---|---|---|---|
| Relative daily insulin dose change | −121.9 (−143.1 to −100.6) | P < 0.0001 | |
| −200−1000100Difference, % (linear scale) |
| Outcome | Estimated treatment difference (95% CI) | P value | |
|---|---|---|---|
| DTSQc scores | 2.6 (1.6–3.5) | P < 0.0001 | |
| −2024Difference (linear scale) |
Safety
| Outcome | Rate ratio (95% CI) | P value | |
|---|---|---|---|
| Severe hypoglycaemia | 0.45 (0.23–0.87) | P = 0.02 | |
| 0.20.5125Rate ratio (log scale) |
Events
| Outcome | Sema+IGlarreduced | IGlartitrated |
|---|---|---|
| Gastrointestinal events | 310 | 32 |
Gastrointestinal events
- No new safety concerns were identified
Original publication
Efficacy and Safety of Once‐Weekly Semaglutide 2.0 mg as an Add‐On to Dose‐Reduced Insulin Glargine versus Dose‐Titrated Insulin Glargine in People With Type 2 Diabetes and Overweight ( SUSTAIN OPTIMIZE ). Diabetes Obes Metab. Published 26 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →