Semaglutide—the “new kid on the block” in the field of glucagonlike peptide-1 receptor agonists?

It is a known fact that, due to the progressive nature of type 2 diabetes (T2D) and decline of beta cell function, diabetes patients require over time treatment intensification to maintain good glycemic control (1,2). In addition, international treatment guidelines recommend achieving glycemic targets while minimizing the risk of hypoglycemia and weight gain, two of the most frequent adverse effects of “classical” diabetes medications (1,2). The last decade witnessed the advent of the glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs), one of the most promising classes of “modern” diabetes medications (3). GLP-1RAs decrease glycaemia by stimulating insulin secretion from the pancreatic beta cells in a glucose dependent manner and inhibiting glucagon secretion from the pancreatic alpha cells, in the same time promoting satiety (direct effect on cerebral GLP-1 receptors and prolongation of gastric emptying), and, consequently, weight loss (4).