High-Dose Semaglutide for Weight Reduction in Overweight Patients with Diabetes

The manufacturer-supported STEP 1 and STEP 3 trials examined use of semaglutide as a weight-loss drug in obese nondiabetic patients (NEJM JW Gen Med Mar 15 2021 and N Engl J Med 2021 Feb 10; [e-pub]; NEJM JW Gen Med Apr 1 2021 and JAMA 2021 Feb 24; [e-pub]). Now, in the industry-supported, randomized STEP 2 trial, researchers looked at weight reduction with semaglutide in overweight patients with type 2 diabetes. Participants received a weekly subcutaneous injection of 2.4 mg of semaglutide (a weight-reduction dose not yet FDA-approved), 1.0 mg of semaglutide (the maximal dose approved to treat diabetes), or placebo. At baseline, mean weight was 100 kg, mean body-mass index was 36 kg/m², and mean glycosylated hemoglobin (HbA_1c) was 8.1%. Al…