Type-2 diabetes is the original GLP-1 indication and remains the largest payer-covered market for the class. Coverage on Peptide News Digest centers on Phase 3 readouts that move prescribing — SURPASS for tirzepatide, ACHIEVE for orforglipron, the SUSTAIN series for semaglutide — and on the cardiometabolic evidence that has expanded the indication framing.
A few threads beyond the core GLP-1s: Merck's enlicitide-decanoate (PCSK9) for related lipid management, and the Foundayo (orforglipron) launch as the first small-molecule oral GLP-1 to hit the T2D market. Real-world Truveta and IQVIA data continues to track how the trial signals translate to 12-month routine care.
Stories here cover Phase 3 readouts, head-to-head comparisons, and payer coverage decisions. See #diabetes for the broader category and #obesity for the weight-loss-specific thread.
A Frontiers in Endocrinology multicenter retrospective cohort study (2026) reports real-world safety and effectiveness of semaglutide in patients with type 2 diabetes and end-stage renal disease — the population systematically excluded from FLOW (which capped at eGFR ≥ 25) and the SELECT pre-specified kidney composite analysis. ESRD patients comprise roughly 1% of the diabetic population but 7% of US healthcare spending; their cardiovascular event rates are among the highest documented. The cohort fills a clinical gap: prescribers managing dialysis-dependent patients have had to extrapolate from outcome trials that explicitly excluded the population. Work joins the SOUL oral-semaglutide CKD analysis as the fastest-growing GLP-1 evidence stream beyond obesity and T2D.
On the April 30 Q1 2026 call, Eli Lilly disclosed positive topline results from TRANSCEND T2D1, the first Phase 3 trial of retatrutide (triple GLP-1/GIP/glucagon agonist) in adults with type 2 diabetes. Compared with placebo, retatrutide lowered A1c by an average of 1.7 to 2.0 percentage points across doses and produced mean weight loss of 11.1 to 16.6 kilograms (25 to 37 pounds). The data complement the previously reported TRIUMPH-4 obesity-with-knee-osteoarthritis results (28.7% weight loss, 75.8% pain reduction). TRIUMPH-1, an 80-week obesity study, is the next retatrutide readout expected, with seven additional Phase 3 readouts still to come in 2026 ahead of a planned regulatory submission late 2026 or 2027.
Novo Nordisk announced May 1 that Ozempic (semaglutide) tablets at 1.5 mg, 4 mg, and 9 mg will be available across 70,000+ U.S. pharmacies starting Monday, May 4, for adults with type 2 diabetes. The product is the only FDA-approved oral peptide GLP-1 medication cleared for both primary and secondary cardiovascular risk reduction in adults with T2D, manufactured end-to-end in the United States. Insured patients can access the pill for as little as $25 for up to a 3-month supply; self-pay patients face $149–$299/month depending on dose strength.
WeightWatchers announced May 1 that its Med+ platform and affiliated medical groups will begin offering Ozempic pill (oral semaglutide) for clinically eligible members with type 2 diabetes. Many eligible members can access the medication for as low as $25/month with pharmacy benefits. The expansion adds a once-daily oral GLP-1 alongside the existing Med+ portfolio of clinically supervised weight-management and metabolic-health treatments, giving WW a foothold in T2D care to complement its weight-loss positioning.
Eli Lilly announced positive topline results from ACHIEVE-4, the longest Phase 3 study of Foundayo (orforglipron) to date in 2,700+ adults with type 2 diabetes across 15 countries. The pre-planned analysis showed a 57% lower risk of all-cause death (HR 0.43, p=0.002), while meeting non-inferiority for the prespecified cardiovascular endpoint (HR 0.84). Lilly plans to submit Foundayo for type 2 diabetes to the FDA by end of Q2.
Retatrutide met its primary endpoint of superior A1C reduction and all key secondary endpoints at 40 weeks compared with placebo in type 2 diabetes patients, also demonstrating significant weight loss.
Eli Lilly's triple agonist (GIP/GLP-1/glucagon) retatrutide met its primary A1C reduction endpoint and all key secondary endpoints at 40 weeks in the TRANSCEND-T2D-1 trial.