Precision selection of glucose-lowering therapy is critical for people with type 2 diabetes. Researchers at EASD 2025 presented an updated five-drug class treatment selection model, originally developed using routine clinical data, to include semaglutide—both oral and injectable formulations.

Using UK primary care data, 2,273 oral semaglutide users and 5,114 injectable users were analyzed. Baseline characteristics were mean HbA1c 74.3 mmol/mol, age 58.6 years, and body mass index 36.4 kg/m². At 12 months, oral semaglutide responses aligned with previous GLP-1 receptor agonist initiations, requiring no adjustments. Injectable semaglutide demonstrated a higher HbA1c reduction (7.3 mmol/mol), necessitating model recalibration.

Following the update, predictions of semaglutide efficacy relative to other drug classes demonstrated excellent calibration. This model enhancement allows clinicians to more accurately identify optimal therapy for individual patients, supporting evidence-based, personalized diabetes care and facilitating the global implementation of precision treatment strategies.