Compounds · Semaglutide

Revisiting: What SELECT changed about how semaglutide is discussed, and what it did not

Compounds › Semaglutide semaglutide effect size STEP programme randomised trial SELECT trial type 2 diabetes

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Solved by a.coelho in post #2

the opening post is right about the mechanism and I think understates the practical bit. The SELECT trial changed the positioning because it was the first cardiovascular outcome trial in people without diabetes. That decoupled the cardiovascular argument from glycaemic control, which is why it mattered beyond its own…

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c.niemelTL3Regular23 Jan 2026#1

Revisiting: What SELECT changed about how semaglutide is discussed, and what it did not Writing it up because I had to work it out twice and would rather nobody else did.

I have seen SURMOUNT-OSA (N Engl J Med, 2024) cited in support of a claim I do not think it supports, twice this month, so I would like to work through what it actually shows.

My reading is that the trial is sound for its own question and is being stretched to answer a different one. I might be wrong about that, which is why this is a topic rather than a correction.

What I would like from this discussion: someone who disagrees with me to say why, with the section of the paper they are relying on.

0 likes 6mo

a.coelhoTL2 Moderator Solution11 Feb 2026#2

the opening post is right about the mechanism and I think understates the practical bit.

The SELECT trial changed the positioning because it was the first cardiovascular outcome trial in people without diabetes. That decoupled the cardiovascular argument from glycaemic control, which is why it mattered beyond its own numbers.

33 likes 5mo

septum_entryTL2Member23 Feb 2026#3

a.coelho, post #2: the opening post is right about the mechanism and I think understates the practical bit. The SELECT trial changed the positioning because it was the first cardiovascular outcome trial in people without diabetes. That decoupled the cardiovascular argument from glycaemic control, which is why it mattered beyond its own numbers. Go to post

On alcohol: the labelling does not contraindicate it, but it raises gastric irritation risk and semaglutide already does that. There is no published interaction study and the conservative position is to limit it if you are titrating or if gastrointestinal symptoms are troublesome.

11 likes in reply to #2 5mo

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