Switching from dulaglutide to semaglutide provides additional blood sugar and weight reduction in real-world patients
In 123 real-world patients with type 2 diabetes, switching from weekly dulaglutide to weekly semaglutide produced an additional 0.54% HbA1c reduction and 5.4 kg weight loss at 18 months, with no increase in side effects.
Quick Facts
What This Study Found
After switching from dulaglutide to semaglutide, patients achieved additional HbA1c reductions of -0.43% (6 mo), -0.54% (12 mo), -0.38% (18 mo), and additional weight loss of -2.7 kg (6 mo), -3.7 kg (12 mo), -5.4 kg (18 mo), -4.2 kg (24 mo), with no significant increase in adverse effects.
Key Numbers
123 patients. Prior dulaglutide duration: 16.9 months. Dulaglutide reduced HbA1c by 0.38% and weight by 1.3 kg. After switching to semaglutide: additional HbA1c reductions of 0.43% (6 mo), 0.54% (12 mo), 0.38% (18 mo), 0.12% (24 mo). Additional weight loss up to 5.5 kg.
How They Did This
Real-world observational cohort study (SEMA-SWITCH) of 123 patients with T2DM who switched from subcutaneous dulaglutide to subcutaneous semaglutide, followed for up to 24 months with HbA1c and weight measurements.
Why This Research Matters
Many patients on GLP-1 drugs reach a plateau or have suboptimal results. This study provides real-world evidence that switching between GLP-1 agonists—specifically from dulaglutide to semaglutide—can unlock additional metabolic benefits without added risk.
The Bigger Picture
As the GLP-1 drug class expands, clinicians need data on switching between agents. This study confirms that not all GLP-1 agonists are equivalent—semaglutide appears more potent than dulaglutide for both glycemic control and weight loss, making intra-class switching a viable clinical strategy.
What This Study Doesn't Tell Us
Observational design without a control group (no comparison to continuing dulaglutide). Selection bias: patients who switched may have been more motivated. Relatively small sample size. HbA1c benefit diminished by 24 months. No randomization.
Questions This Raises
- ?Would patients who are responding adequately to dulaglutide still benefit from switching to semaglutide?
- ?Does the diminishing HbA1c benefit at 24 months suggest a semaglutide plateau similar to dulaglutide?
- ?How would tirzepatide compare as a switch option for patients with inadequate dulaglutide response?
Trust & Context
- Key Stat:
- -5.4 kg additional weight loss Peak additional weight loss at 18 months after switching from dulaglutide to semaglutide, on top of prior dulaglutide-related weight loss
- Evidence Grade:
- Real-world observational study with reasonable follow-up (24 months) but lacks randomization and control group. Provides practical clinical guidance but lower evidence grade than an RCT.
- Study Age:
- Published in 2025; represents current real-world data on GLP-1 agonist switching strategies.
- Original Title:
- Real-world evaluation of the efficacy and safety of switching from weekly dulaglutide to weekly semaglutide: The SEMA-SWITCH study.
- Published In:
- Endocrinologia, diabetes y nutricion, 72(6), 501574 (2025)
- Authors:
- Pardo Lozano, Felipe, Rubio Marcos, Arantxa, Casañ Fernández, Rosa, Bartual Rodrigo, Amparo, Martínez-Hervás, Sergio, Ampudia-Blasco, Francisco Javier
- Database ID:
- RPEP-12954
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Why would someone switch from dulaglutide to semaglutide?
Common reasons include not achieving target blood sugar levels, wanting more weight loss, or experiencing gastrointestinal side effects with dulaglutide. Both are weekly GLP-1 injections, but semaglutide has shown greater potency for both glycemic control and weight loss in clinical trials.
Is it safe to switch between GLP-1 drugs?
This study found no significant increase in adverse effects when switching from dulaglutide to semaglutide. Patients tolerated the switch well while gaining additional metabolic benefits. However, individual responses vary, and any medication change should be discussed with a healthcare provider.
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Cite This Study
https://rethinkpeptides.com/research/RPEP-12954APA
Pardo Lozano, Felipe; Rubio Marcos, Arantxa; Casañ Fernández, Rosa; Bartual Rodrigo, Amparo; Martínez-Hervás, Sergio; Ampudia-Blasco, Francisco Javier. (2025). Real-world evaluation of the efficacy and safety of switching from weekly dulaglutide to weekly semaglutide: The SEMA-SWITCH study.. Endocrinologia, diabetes y nutricion, 72(6), 501574. https://doi.org/10.1016/j.endien.2025.501574
MLA
Pardo Lozano, Felipe, et al. "Real-world evaluation of the efficacy and safety of switching from weekly dulaglutide to weekly semaglutide: The SEMA-SWITCH study.." Endocrinologia, 2025. https://doi.org/10.1016/j.endien.2025.501574
RethinkPeptides
RethinkPeptides Research Database. "Real-world evaluation of the efficacy and safety of switchin..." RPEP-12954. Retrieved from https://rethinkpeptides.com/research/pardo-2025-realworld-evaluation-of-the
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Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.