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In recent years, new drugs for the treatment of T2D have expanded to include glucagon-like peptide 1 receptor agonists (GLP-1RAs), dipeptidyl peptidase 4 inhibitors (DPP-4is), and sodiumglucose cotransporter 2 inhibitors (SGLT2is)

Mechanism of Action Enhances glucose-dependent insulin secretion Suppresses glucagon release Delays gastric emptying Promotes satiety via central appetite regulation Pharmacokinetics Route: Subcutaneous (once weekly) Half-life: ~1 week Metabolism: Proteolytic degradation Excretion: Urine and feces Clinical Benefits HbA1c reduction of ~11.5% Significant weight loss (515%) Proven cardiovascular protection Minimal risk of hypoglycemia when used alone Adverse Effects Common: Nausea, vomiting, diarrhea Rare: Pancreatitis, gallbladder disease Contraindicated in medullary thyroid carcinoma / MEN-2 The Bigger Picture -The transition of semaglutide from a high-cost, premium therapy to an affordable mass drug represents a paradigm shift