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Semaglutide Treatment in Young Adults Living With Type 2 Diabetes: A Post Hoc Analysis From the SUSTAIN and PIONEER Clinical Trials

Zaccardi F, Aroda VR, Arslan EG, Bardtrum L, Goldney J, Ising E, Priyadarshini P, Slater T et al.

Diabetes, obesity & metabolism, 2026

Abstract

Aims: Young adults (aged ≤ 40 years) are underrepresented in clinical trials that investigate interventions for those living with Type 2 diabetes (T2D). This study evaluated the efficacy of semaglutide treatment in young adults with T2D by examining the effects on HbA1c and body weight (BW) during the SUSTAIN and PIONEER programmes compared to placebo and active comparators, according to age at study enrolment. This study also assessed aggregated safety data across age subgroups.

Materials and methods: This post hoc analysis of the SUSTAIN (once-weekly subcutaneous administration) and PIONEER (once-daily oral administration) programmes assessed the efficacy of semaglutide treatment in different age subgroups by comparing change in HbA1c and BW between young adults with T2D (≤ 40 years), middle-aged adults with T2D (> 40- ≤ 50 years), and middle older-aged adults with T2D (> 50 years). Selected safety outcomes were assessed, focusing on serious adverse events (SAEs) and gastrointestinal SAEs from the programmes.

Results: Findings indicate a reduction in HbA1c levels and BW in participants across all age subgroups that were treated with semaglutide, particularly in young adults versus other age subgroups. The proportion of participants experiencing SAEs was overall comparable between semaglutide treatment and comparators across age subgroups and administration route.

Conclusions: Semaglutide shows notable and consistent efficacy in reducing HbA1c and BW across all age…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

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