Side by side

1. 1.After injection it binds GLP-1 receptors on cells in the pancreas, gut, and appetite centres of the brain.
2. 2.In the pancreas it increases insulin release and reduces glucagon release, but mainly when blood glucose is already high — which is why it rarely causes hypoglycaemia on its own.
3. 3.It slows gastric emptying, so nutrients reach the small intestine over a longer period.
4. 4.It signals the hypothalamus to reduce hunger and food intake.
5. 5.Together these lower blood glucose and body weight.

• Type 2 diabetes (SUSTAIN programme)
• Chronic weight management in obesity (STEP programme)
• Cardiovascular outcomes in type 2 diabetes (SUSTAIN-6)
• Fatty liver disease
• Kidney outcomes in diabetes
• Appetite regulation in binge-eating and alcohol-use research (early trials)

• HbA1c reduction of roughly 1.5 percentage points in randomised trials
• About 15% mean weight loss at 68 weeks with the 2.4 mg weekly dose (STEP 1)
• Fewer major cardiovascular events in adults with diabetes at high cardiovascular risk
• Slower gastric emptying and measurably reduced appetite
• Reduced liver fat in imaging sub-studies

• Nausea, vomiting and diarrhoea, most common during dose escalation
• Constipation, reflux and abdominal pain
• Appetite loss severe enough to reduce overall nutrient intake
• Gallbladder disease, including gallstones
• Pancreatitis (rare)
• Thyroid C-cell tumours in rodents — human relevance is not established

Research context only — semaglutide is a prescription medicine and its use is determined by a doctor. In published trials the weight-management dose was escalated from 0.25 mg to 2.4 mg subcutaneously once weekly over about 16 weeks; diabetes doses were typically 0.5–1 mg weekly. Trial durations ran 40–104 weeks. Nothing here is a dosing suggestion, and unprescribed use carries real risk.

Research context only