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[11] In a randomized controlled trial (RCT) comparing liraglutide, glargine, glimepiride, and sitagliptin (all added to metformin) with a follow-up of five years, glargine and liraglutide were modestly more effective in achieving and maintaining target HbA1c, [20] with no difference in outcomes of microvascular and cardiovascular disease

Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): A 56-week, double-blind, phase 3a, randomised trial

Both patients began experiencing resolution of their symptoms within 1 month of discontinuing semaglutide

While metformin is often prescribed to non-pregnant people with T2DM, other drugs or insulin may be added or substituted for metformin if adequate blood sugar control is not achieved

rare but serious risks include diabetic ketoacidosis

In Pennsylvania, a $3.5 billion facility in Fogelsville, announced in January 2026 and beginning construction in 2026, will manufacture tirzepatide and next-generation peptides including retatrutide, with completion expected in 2031