Clinical trial summaries for GLP-1 receptor agonists, including cardiovascular outcomes, glycaemic control, obesity, kidney outcomes, tolerability, and practice implications.
A 2-year pragmatic open-label trial finds once-weekly semaglutide modestly outperforms physician-chosen alternatives on HbA1c targets, with a year-1 weight advantage that fades by year 2. PICO summary and commentary.
A small mechanistic trial in youth-onset type 2 diabetes finds metformin and liraglutide shift gut bacteria and bile acids; bile-acid metabolites, not microbiota shifts, track with glucose. PICO summary and commentary.
A clamp study finds tirzepatide preserves the glucagon defence against hypoglycaemia but delays cortisol/noradrenaline and lowers symptom scores, while awareness is unchanged. PICO summary and commentary.
A prespecified SUMMIT analysis finds tirzepatide reduces heart-failure events in obese HFpEF regardless of diabetes status, despite less weight loss with diabetes. PICO summary and commentary.
A SURMOUNT-1 analysis finds tirzepatide improves insulin sensitivity (mostly via weight loss) and beta-cell function (mostly drug-driven) in obesity without diabetes. PICO summary and commentary.
A SURMOUNT-1 analysis finds 90% of early non-responders to tirzepatide still reached 5% weight loss by week 72, supporting extending treatment. PICO summary and commentary.
A randomized open-label pilot trial tested whether slower, flexible semaglutide titration reduces gastrointestinal dropout in type 2 diabetes versus the label regimen. PICO summary and expert commentary.
A phase IV randomized trial in 90 adults with type 2 diabetes found dapagliflozin plus exenatide augmented beta-cell function and insulin sensitivity above either agent alone, on surrogate OGTT measures. PICO summary and expert commentary.
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