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STEP 2 studied semaglutide 2.4 mg in adults with type 2 diabetes and overweight or obesity. At 68 weeks, semaglutide 2.4 mg produced substantially greater weight loss than placebo and greater loss than the 1.0-mg diabetes dose. Glycemic measures and several cardiometabolic outcomes also improved. The study is useful for physicians managing the common triad of diabetes, obesity and cardiovascular risk. It demonstrates that treatment intensity and therapeutic goals can be tailored to the patient's phenotype rather than treating HbA1c in isolation. Gastrointestinal symptoms were common, and long-term continuation is important because obesity is a chronic disease and weight regain can follow treatment withdrawal. In practice, semaglutide should be introduced with clear expectations about dose escalation, nutrition, physical activity and monitoring. The broader lesson is that modern diabetes therapy can simultaneously address glycemic control and excess adiposity, which may improve the overall risk profile of appropriately selected patients.

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STEP 2 studied semaglutide 2.4 mg in adults with type 2 diabetes and overweight or obesity. At 68 weeks, semaglutide 2.4 mg produced substantially greater weight loss than placebo and greater loss than the 1.0-mg diabetes dose. Glycemic measures and several cardiometabolic outcomes also improved. The study is useful for physicians managing the common triad of diabetes, obesity and cardiovascular risk. It demonstrates that treatment intensity and therapeutic goals can be tailored to the patient's phenotype rather than treating HbA1c in isolation. Gastrointestinal symptoms were common, and long-term continuation is important because obesity is a chronic disease and weight regain can follow treatment withdrawal. In practice, semaglutide should be introduced with clear expectations about dose escalation, nutrition, physical activity and monitoring. The broader lesson is that modern diabetes therapy can simultaneously address glycemic control and excess adiposity, which may improve the overall risk profile of appropriately selected patients.
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