Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-35 long-acting GLP1RAs do lower postprandial glucose excursions for all meals of the day, but predominantly lower fasting plasma concentrations of glucose.

A 26-week, multi-center double-blind trial randomized 705 participants with type 2 diabetes to once- daily semaglutide, liraglutide or placebo in one of four volume-matched doses. Treatment with semaglutide lowered A1C by − 1.1% to − 1.9% and with liraglutide from − 0.5% to − 1.3% (1.8 mg) (all p<0.001 in favor of volume-matched semaglutide dose). However, there were significantly more GI adverse events with semaglutide than liraglutide (75). In terms of GLP-1 RA agents demonstrating CV benefit, the strongest evidence is for dulaglutide, followed by liraglutide, followed by subcutaneous semaglutide. There is no evidence of CV benefit for lixisenatide and the CV benefits of exenatide-ER and oral semaglutide remain unproven. To further substantiate the evidence of CV risk reduction with oral semaglutide, Novo Nordisk is currently conducting the CV outcome trial, SOUL, in people with type 2 diabetes. SOUL is estimated to complete in 2024.