General information with sources. Never a substitute for your doctor.

MethodologyAbout the authorESEN
SaciedadSearch

Randomized controlled trial

STEP 2: semaglutide 2.4 mg (Wegovy) in type 2 diabetes

In people with type 2 diabetes, semaglutide 2.4 mg once weekly reduced weight by 9.6% at 68 weeks, compared with 3.4% on placebo; the estimated difference was −6.2 percentage points (95% CI, −7.3 to −5.2).

Davies M et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet, 2021. DOI: 10.1016/S0140-6736(21)00213-0

Prepared by
Last updated
Sources
2 sources

No clinical review. No advertising from drug companies and no affiliate links.How we work

Key facts

Drug
semaglutide
Design
Randomized controlled trial
Participants
1,210
Duration
68 weeks
Funding
Novo Nordisk
Population
1,210 adults with type 2 diabetes, a BMI of 27 or more and an HbA1c between 7% and 10%, at 149 sites in 12 countries.
Primary outcome
Percentage change in body weight and proportion losing at least 5% at 68 weeks, semaglutide 2.4 mg versus placebo.

What it found

Mean weight loss, % of starting weight · 68 weeks
  • Semaglutide 2.4 mg weekly−9.6%
  • Placebo−3.4%

Difference: −6.2 points vs placebo (95% CI, −7.3 to −5.2).

Figures from the paper and the EU labelSee the results in a chart

In people with type 2 diabetes, semaglutide 2.4 mg once weekly reduced weight by 9.6% at 68 weeks, compared with 3.4% on placebo; the estimated difference was −6.2 percentage points (95% CI, −7.3 to −5.2). A third group on semaglutide 1.0 mg (the diabetes dose) served as an active comparison. Of the participants on 2.4 mg, 68.8% lost at least 5% of their weight, compared with 28.5% on placebo. Digestive adverse effects, mostly mild or moderate, affected 63.5% on 2.4 mg, 57.5% on 1.0 mg and 34.3% on placebo.

Limitations

Funded by Novo Nordisk. Weight loss was smaller than in STEP 1, which is common in people with type 2 diabetes. The comparison with semaglutide 1.0 mg was not the main objective of the trial.

What it means for you

In people with type 2 diabetes, weight loss with semaglutide 2.4 mg averaged 9.6%, less than in the trials of people without diabetes. If you have diabetes, knowing this helps set realistic expectations. Your doctor can explain what to expect in your case.

Further reading

Related trials

  • semaglutide72 weeks

    STEP UP T2D

    At 72 weeks, weight had changed by −13.2% with semaglutide 7.2 mg and by −3.9% with placebo.

  • semaglutide72 weeks

    STEP UP

    At 72 weeks, weight changed by −18.7% with semaglutide 7.2 mg, −15.6% with 2.4 mg and −3.9% with placebo.

  • semaglutide52 weeks

    STEP-HFpEF

    At 52 weeks, the KCCQ-CSS score improved by 16.6 points with semaglutide and 8.7 with placebo, and weight changed by −13.3% versus −2.6%.

  • semaglutide120 weeks

    STEP 1 (extension)

    From week 0 to week 68, weight fell by an average of 17.3% with semaglutide and 2.0% with placebo.

Sources

The original paper and the records consulted for this summary, with the date they were accessed.

  1. The Lancet.Davies M, et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet. 2021;397(10278):971-984.accessed .
  2. National Library of Medicine (PubMed).PubMed record PMID 33667417 (abstract).accessed .