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.
Semaglutide half-life: where the 165 to 184 hour figure comes from
The C-cell question: semaglutide triggered medullary thyroid carcinoma in rodent toxicology studies. A signal in rodents does not automatically appear in humans, but it is the reason the compound is contraindicated in people with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2.
The STEP programme populations were selected: enrollment criteria required baseline body mass index over 30, no recent blood pressure crisis, no recent retinopathy, no renal disease at the time. Applying results from that population to someone well outside it is an extrapolation and should be called one.
Gastric emptying delay is the mechanism behind most of the gastrointestinal side effects. Slowing the stomach empties it feeds less food into the intestines at a time, which is part of the satiety mechanism but is also why nausea is dose-dependent and titration-dependent.
On post #77 — agreed on the reasoning, with one qualification.
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.
On post #100 — agreed on the reasoning, with one qualification.
Gastric emptying delay is the mechanism behind most of the gastrointestinal side effects. Slowing the stomach empties it feeds less food into the intestines at a time, which is part of the satiety mechanism but is also why nausea is dose-dependent and titration-dependent.
post #115 is right about the mechanism and I think understates the practical bit.
Approved indications differ by jurisdiction and change. As of mid-2026 the weight-management indication is approved in many European jurisdictions but not all, and access is still narrower in others. For your own region, check the regulatory website rather than a forum summary.
Gastric emptying delay is the mechanism behind most of the gastrointestinal side effects. Slowing the stomach empties it feeds less food into the intestines at a time, which is part of the satiety mechanism but is also why nausea is dose-dependent and titration-dependent.
I disagree with the reply above, and I think the disagreement is substantive rather than terminological.
The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.
Read the full topic (146 posts)
This topic was referenced in
- Semaglutide in people without diabetes: what the evidence base looks likeCompounds › Semaglutide · 6 replies
- Tracking semaglutide's approved indications across jurisdictions, datedCompounds › Semaglutide · 19 replies
- Follow-up: Semaglutide versus liraglutide head to head: reading STEP 8 carefullyCompounds › Semaglutide · 5 replies
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