Best GLP-1 for Type 2 Diabetes: Ranked by A1C, Heart, Cost
Ozempic, Rybelsus, Mounjaro, Trulicity, Victoza and Byetta are FDA approved for type 2 diabetes; the other GLP-1s are not. In SURMOUNT-5, people on Zepbound lost 20.2% of body weight on average.
- Approved for type 2 diabetes
- 6 of 10 brands
- Best result (SURMOUNT-5)
- 20.2% weight loss
Weight loss and half-life at a glance
Half-life in days: how long the body needs to clear half of a dose, based on section 12.3 in each FDA label.
A percentage of body weight. Trials, doses and lengths differ, so check each one against the placebo shown on its page.
Is GLP-1 approved for type 2 diabetes?
| Medicine | For type 2 diabetes | How it is taken | Trial result |
|---|---|---|---|
 Ozempic | FDA approved | weekly injection | Not listed |
 Rybelsus | FDA approved | daily tablet | Not listed |
 Mounjaro | FDA approved | weekly injection | A1C down 2.3 points |
 Trulicity | FDA approved | weekly injection | A1C down 1.77 points |
 Victoza | FDA approved | daily injection | Not listed |
| Byetta | FDA approved | twice-daily injection | Not listed |
 Wegovy | Not an approved use | weekly injection or daily tablet | 9.6% weight loss |
 Zepbound | Not an approved use | weekly injection | 14.7% weight loss |
 Foundayo | Not an approved use | daily tablet | 9.6% weight loss |
 Saxenda | Not an approved use | daily injection | 7.4% weight loss |
Sources: FDA label (DailyMed), PubMed.
Who qualifies?
| Medicine | Who qualifies |
|---|---|
| Ozempic | Used alongside diet and exercise, it lowers blood sugar for adults with type 2 diabetes. |
| Ozempic | In adults with type 2 diabetes and heart disease, it lowers the chance of a stroke, a heart attack or death related to the heart. |
| Ozempic | This medicine lowers the chance of worsening kidney disease, of kidney failure, or of death related to the heart in adults with type 2 diabetes and chronic kidney disease. |
| Wegovy | Adults with heart disease plus obesity or overweight see a lower chance of stroke, heart attack or death related to the heart (injection and tablets). |
| Wegovy | Adults and children 12 and older who have obesity, or adults who are overweight and have a weight-related condition: losing weight and keeping it off over the long term, used with diet and activity. |
| Wegovy | In adults, the injection form treats MASH liver disease with moderate to advanced scarring (no cirrhosis). |
| Wegovy | The tablets are approved in adults to support weight loss and lower heart risk. |
| Rybelsus | Used alongside diet and exercise, it lowers blood sugar for adults with type 2 diabetes. |
| Rybelsus | In adults with type 2 diabetes at high risk, it cuts the chance of a stroke, a heart attack or death related to the heart. |
| Mounjaro | Adults and children aged 10 and older who have type 2 diabetes get lower blood sugar from this medicine when it is used with diet and exercise. |
| Mounjaro | In adults with type 2 diabetes at high risk, it cuts the chance of a stroke, a heart attack or death related to the heart. |
| Zepbound | With diet and activity, it supports weight loss and keeping the weight off over the long term for adults with obesity and for adults with overweight and a weight-related condition. |
| Zepbound | In adults with obesity, this treatment is used for obstructive sleep apnea that is moderate to severe. |
| Foundayo | With diet and activity, it supports weight loss and keeping the weight off over the long term for adults with obesity and for adults with overweight and a weight-related condition. |
| Trulicity | Adults and children aged 10 and older who have type 2 diabetes get lower blood sugar from this medicine when it is used with diet and exercise. |
| Trulicity | In adults with type 2 diabetes and heart disease, it lowers the chance of a stroke, a heart attack or death related to the heart or several heart risk factors. |
| Saxenda | Adults and children 12 and older weighing over 60 kg who have obesity, or adults who are overweight and have a weight-related condition: losing weight and keeping it off over the long term, used with diet and activity. |
| Victoza | Adults and children aged 10 and older who have type 2 diabetes get lower blood sugar from this medicine when it is used with diet and exercise. |
| Victoza | In adults with type 2 diabetes and heart disease, it lowers the chance of a stroke, a heart attack or death related to the heart. |
| Byetta | Used alongside diet and exercise, it lowers blood sugar for adults with type 2 diabetes. |
What type 2 diabetes trials showed
| Trial | Medicine | Who took part | Length | People | Main result | Comparison |
|---|---|---|---|---|---|---|
| SURMOUNT-2 | Zepbound | Adults with type 2 diabetes who also have obesity or overweight | 72 weeks | 938 | 14.7% weight loss | 3.2% on placebo |
| SURMOUNT-5 | Zepbound | Adults with obesity, without type 2 diabetes | 72 weeks | 751 | 20.2% weight loss | Not listed |
| SCALE Obesity and Prediabetes | Saxenda | Adults who have obesity or overweight and also have type 2 diabetes | 56 weeks | 3,731 | 7.4% weight loss | 3% on placebo |
| ATTAIN-2 | Foundayo | Adults with type 2 diabetes who also have obesity or overweight | 72 weeks | 1,613 | 9.6% weight loss | 2.5% on placebo |
| STEP 2 | Wegovy | Adults with type 2 diabetes who also have obesity or overweight | 68 weeks | 1,210 | 9.6% weight loss | 3.4% on placebo |
| SURPASS-2 | Mounjaro | Adults with type 2 diabetes on metformin | 40 weeks | 1,879 | A1C down 2.3 points | Not listed |
| SURPASS-1 | Mounjaro | Adults with type 2 diabetes who use only diet and exercise | 40 weeks | 478 | A1C down 2.07 points | Not listed |
| ACHIEVE-1 | Foundayo | Adults with early type 2 diabetes using diet and exercise only | 40 weeks | 559 | A1C down 1.48 points | down 0.41 points on placebo |
| AWARD-11 | Trulicity | Adults with type 2 diabetes on metformin | 36 weeks | 1,842 | A1C down 1.77 points | Not listed |
Trial sources: SURMOUNT-2 (PubMed), SURMOUNT-5 (PubMed), SCALE Obesity and Prediabetes (FDA label (DailyMed)), ATTAIN-2 (FDA label (DailyMed)), STEP 2 (PubMed), SURPASS-2 (PubMed), SURPASS-1 (PubMed), ACHIEVE-1 (PubMed), AWARD-11 (PubMed).
Coverage for type 2 diabetes
| What changes | What the label says | Labels |
|---|---|---|
| Diabetic Retinopathy Complications | Diabetic eye disease can get worse in those who have type 2 diabetes, and this is especially likely when blood sugar drops quickly. Eye checks matter if you already have it. | Ozempic and Rybelsus |
| Hypoglycemia When Used Together With Insulin Secretagogues or Insulin | Low blood sugar is more likely when you use it with insulin or a sulfonylurea, so those doses may need to be lowered. | All of them |
| Complications of Diabetic Retinopathy in Patients With Type 2 Diabetes | Diabetic eye disease can get worse in those who have type 2 diabetes, and this is especially likely when blood sugar drops quickly. Eye checks matter if you already have it. | Wegovy, Mounjaro, Zepbound, Foundayo and Trulicity |
| Taken with insulin or sulfonylureas | Low blood sugar becomes more likely when you take this medicine with insulin or a sulfonylurea medicine such as glipizide or glimepiride. Your doctor may then reduce those doses. | All of them |
Warnings in the label come from: FDA label (DailyMed).
Coverage for type 2 diabetes
Medicare Part D can cover these medicines when they are prescribed for diabetes or cardiovascular disease.
Sources: humana.com.
- Ozempic Coupon
- Ozempic Cost
- Ozempic Cost Without Insurance
- Ozempic Cost With Insurance
- Is Ozempic Covered by Insurance? Criteria, Copay, Appeal
- Does Medicare Cover Ozempic? Part D Rules and the GLP-1 Bridge
- Ozempic Patient Assistance
- Cheapest Way to Get Ozempic
- Does Medicaid Cover Ozempic? Criteria, Copay, How to Appeal
Questions for your prescriber
- In the future, could the other diabetes medicines I take need to change, especially insulin or a sulfonylurea?
- How often should I have my eyes checked?
- What A1C goal should I set?