What is it about?
Should semaglutide replace metformin as first-line therapy in type 2 diabetes? With evidence from SELECT, SUSTAIN-6, and SOUL trials showing superior cardiometabolic outcomes, it's time to re-evaluate our foundational treatment strategies and prioritize head-to-head trials comparing monotherapy efficacy, safety, and cost-effectiveness.
Featured Image
Photo by Sweet Life on Unsplash
Why is it important?
We issue a call to action for the research community to prioritize well-designed head-to-head clinical trials of first-line therapies in type 2 diabetes, particularly in light of the spike of semaglutide use in recent years, with the goal of clarifying comparative efficacy, safety, and overall clinical benefit, and ultimately informing evidence-based treatment guidelines.
Perspectives
I was inspired to write this letter because semaglutide use has become increasingly common in recent years, and so far, we haven’t seen any major safety issues. That got me thinking, why not put semaglutide and metformin side by side and see how they truly compare as first-line treatments for type 2 diabetes?
Muaz Ahmed
Akhtar Saeed Medical and Dental College
Read the Original
This page is a summary of: First-Line Therapy: Semaglutide Rise, Diabetes Care, November 2025, American Diabetes Association,
DOI: 10.2337/dc25-1032.
You can read the full text:
Contributors
The following have contributed to this page
