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Study · Randomized controlled trial · n = 573 · 2026

7 results

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).

Rodbard HW, Irace C, Lobo J, Makrilakis K, Priyadarshini P, Sivalingam S, Povedano ST, Bhargava A

Diabetes, obesity & metabolism26 Jul 2026Cited by 1 (Europe PMC)

PMID42504064 (opens in a new tab)PMCIDPMC13538791 (opens in a new tab)DOI10.1111/dom.71132 (opens in a new tab)PepBankPUB-42504064
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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: CC BY-NC. Results still quote short attributed sentences.

Results from this study7

7 results from studies that gave the peptide. 7 results from people.

  1. 01HumanRandomized controlled trialEfficacy outcome

    In adults with type 2 diabetes and overweight, semaglutide 2.0 mg added to dose-reduced insulin glargine lowered HbA1c more than dose-titrated insulin glargine (ETD -0.74%), meeting non-inferiority and superiority.

    In plain wordsIn adults with type 2 diabetes and overweight, adding semaglutide to reduced insulin lowered HbA1c more than increasing insulin alone.

    Peptide
    Semaglutide
    Outcome
    DecreaseHbA1c change at week 40
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Analysis
    Primary
    Outcome group
    Glycemic control · Metabolic and weight
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Measurements

    Estimated treatment difference in HbA1c
    −0.74%
    Sema+IGlar reduced versus IGlar titrated

    Source sentences

    Summary
    Sema+IGlarreduced achieved both non-inferiority and superiority versus IGlartitrated in HbA1c reduction (estimated treatment difference [ETD]: -0.74%; 95% confidence interval [CI95]: -0.90, -0.59)
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.
  2. 02HumanRandomized controlled trialEfficacy outcome

    In adults with type 2 diabetes and overweight, semaglutide added to dose-reduced insulin glargine reduced body weight more than dose-titrated insulin glargine (ETD -8.5 kg).

    In plain wordsIn adults with type 2 diabetes and overweight, adding semaglutide to reduced insulin led to more weight loss than increasing insulin alone.

    Peptide
    Semaglutide
    Outcome
    DecreaseBody weight change
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Analysis
    Secondary
    Outcome group
    Body weight · Metabolic and weight
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Measurements

    Estimated treatment difference in body weight
    −8.5 kg
    Sema+IGlar reduced versus IGlar titrated

    Source sentences

    Summary
    superiority in BW change (ETD: -8.5 kg; CI95: -9.5, -7.4)
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.
  3. 03HumanRandomized controlled trialEfficacy outcome

    In adults with type 2 diabetes and overweight, semaglutide added to dose-reduced insulin glargine reduced the relative daily insulin dose more than dose-titrated insulin glargine (ETD -121.9%).

    In plain wordsIn adults with type 2 diabetes and overweight, adding semaglutide meant a much smaller daily insulin dose than increasing insulin alone.

    Peptide
    Semaglutide
    Outcome
    DecreaseRelative daily insulin dose change
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Analysis
    Secondary
    Outcome group
    Glycemic control · Metabolic and weight
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Measurements

    Estimated treatment difference in relative insulin dose
    −121.9%
    Sema+IGlar reduced versus IGlar titrated

    Source sentences

    Summary
    relative daily insulin dose change (ETD: -121.9%; CI95: -143.1, -100.6)
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.
  4. 04HumanRandomized controlled trialEfficacy outcome

    In adults with type 2 diabetes and overweight, treatment satisfaction (DTSQc) was higher with semaglutide added to dose-reduced insulin glargine than with dose-titrated insulin glargine (ETD 2.6).

    In plain wordsIn adults with type 2 diabetes and overweight, people adding semaglutide reported higher treatment satisfaction than those increasing insulin alone.

    Peptide
    Semaglutide
    Outcome
    IncreaseTreatment satisfaction (DTSQc score)
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Analysis
    Secondary
    Outcome group
    Patient-reported outcomes · Metabolic and weight
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Measurements

    Estimated treatment difference in DTSQc
    2.6 points
    Sema+IGlar reduced versus IGlar titrated

    Source sentences

    Summary
    DTSQc scores (ETD: 2.6; CI95: 1.6, 3.5) (p < 0.0001 for all endpoints)
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.
  5. 05HumanRandomized controlled trialSafety outcome

    In adults with type 2 diabetes and overweight, no new safety concerns were identified with semaglutide added to dose-reduced insulin glargine.

    In plain wordsIn adults with type 2 diabetes and overweight, no new safety concerns were found when semaglutide was added to reduced insulin.

    Peptide
    Semaglutide
    Outcome
    No significant changeNew safety concerns
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Outcome group
    Adverse events · Whole body
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Source sentences

    Summary
    No new safety concerns were identified.
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.
  6. 06HumanRandomized controlled trialSafety outcome

    In adults with type 2 diabetes and overweight, severe hypoglycaemia was less frequent with semaglutide added to dose-reduced insulin glargine than with dose-titrated insulin glargine (rate ratio 0.45).

    In plain wordsIn adults with type 2 diabetes and overweight, severe low blood sugar was less frequent with semaglutide plus reduced insulin than with more insulin.

    Peptide
    Semaglutide
    Outcome
    DecreaseSevere hypoglycaemia
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Outcome group
    Adverse events · Metabolic and weight
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Measurements

    Rate ratio
    0.45
    severe hypoglycaemia

    Source sentences

    Summary
    Severe hypoglycaemia was reduced (rate ratio: 0.45; CI95: 0.23, 0.87; p = 0.02)
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.
  7. 07HumanRandomized controlled trialSafety outcome

    In adults with type 2 diabetes and overweight, gastrointestinal events were more frequent with semaglutide added to dose-reduced insulin glargine than with dose-titrated insulin glargine (310 vs. 32 events).

    In plain wordsIn adults with type 2 diabetes and overweight, stomach and gut events were more common with semaglutide added to reduced insulin than with more insulin.

    Peptide
    Semaglutide
    Outcome
    IncreaseGastrointestinal events
    Study

    n = 573

    Comparator
    Dose-titrated insulin glargine
    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    2.0 mg once weekly · subcutaneous · 40 weeksAs given in this study (human).

    Measurements

    Gastrointestinal events
    310 events
    Sema+IGlar reduced
    Gastrointestinal events
    32 events
    IGlar titrated

    Source sentences

    Summary
    gastrointestinal events were higher for Sema+IGlarreduced (310 vs. 32 events).
    3 context sentences
    Summary · context
    SUSTAIN OPTIMIZE was a 40-week, phase 3b, open-label, randomised study.
    Summary · context
    Adults with T2D, overweight (body mass index ≥ 25 kg/m2), and treatment with basal insulin ≤ 40 units/day were randomised 1:1 into Sema+IGlarreduced or IGlartitrated.
    Summary · context
    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.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    11 Oct 2026, 00:04 UTC

    Study results updated

  2. Version 1

    9 Oct 2026, 03:06 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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