SOURCE-LINKED STUDY SUMMARY
Semaglutide vs Dulaglutide: Weight & A1C in SUSTAIN 7
PED EVIDENCE INTERPRETATION
How did semaglutide compare directly with dulaglutide?
Semaglutide produced greater weight and HbA1c reductions at both paired dose comparisons over 40 weeks. The study compared 0.5 vs 0.75 mg and 1.0 vs 1.5 mg, respectively, in adults with type 2 diabetes taking metformin. [1]
- Design
- Randomized, open-label, phase 3b SUSTAIN 7 trial; 1,201 participants
- Population
- Type 2 diabetes inadequately controlled on metformin
- Comparison
- Weekly subcutaneous semaglutide 0.5/1.0 mg vs dulaglutide 0.75/1.5 mg
- Duration
- 40 weeks
The evidence at a glance
| Outcome / dose pair | Semaglutide | Dulaglutide | Estimated difference (95% CI) |
|---|---|---|---|
| HbA1c: 0.5 vs 0.75 mg [1] | −1.5 percentage points | −1.1 percentage points | −0.40 (−0.55 to −0.25) |
| HbA1c: 1.0 vs 1.5 mg [1] | −1.8 percentage points | −1.4 percentage points | −0.41 (−0.57 to −0.25) |
| Weight: 0.5 vs 0.75 mg [1] | −4.6 kg | −2.3 kg | −2.26 kg (−3.02 to −1.51) |
| Weight: 1.0 vs 1.5 mg [1] | −6.5 kg | −3.0 kg | −3.55 kg (−4.32 to −2.78) |
OUR READING OF THE EVIDENCE
What this changes
Randomizing the comparator within the same trial makes this more directly informative than ranking separate trials by their average results. [1]
What it does not establish
It does not compare every available dose, establish lifetime safety, or show that an individual will experience the group-average difference. [1]
Put it in context
Sources and transparency
Funded by Novo Nordisk. Abstract-based interpretation; not an independent assessment of all adverse events or methodological quality. [1]
Questions this study helps answer
Did the trial compare today’s highest available doses?
It compared only the four doses listed in the trial. Results cannot settle comparisons involving untested higher doses or different patient populations. [1]
Were these placebo comparisons?
No. SUSTAIN 7 was an open-label active-comparator trial. Both treatments were given alongside metformin, and the result is specific to the paired doses studied. [1]
Original compact summary and study details
- What was studied
- SUSTAIN 7 was a randomized, open-label phase 3b trial comparing weekly semaglutide with dulaglutide; HbA1c and body weight were assessed at week 40.
- Who / model studied
- Participants were adults with type 2 diabetes inadequately controlled on metformin alone.
- Studied dose & schedule
- Dose and schedule have not yet been extracted for this summary.
- What the study found
- At the lower-dose comparison, body weight fell by 4.6 kg with semaglutide and 2.3 kg with dulaglutide.
- Limitations & context
- The study was open-label. Gastrointestinal disorders were the most common reason for discontinuation, and six fatalities occurred across the four groups.
Read summary source ↗ · Prepared 9/22/2026 · AI-assisted, source-based summary
Review record & corrections
Summary prepared: . Source scope: abstract. This is an AI-assisted source summary, not an independent clinician sign-off.
No public field-by-field revision history is available for this card yet. The date above is the summary date, not proof that every field was updated then.
Inspect the source · Correction policyResearch findings apply to the population and conditions studied. This educational summary is not a treatment recommendation or a formal assessment of study quality.
Original publication ↗ · DOI: 10.1016/s2213-8587(18)30024-x