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ForumsSemaglutide (Ozempic / Wegovy)A1C reduction on semaglutide: SUSTAIN program meta-analysis Page 2

A1C reduction on semaglutide: SUSTAIN program meta-analysis

A1cHero_PHX Tue, May 19, 2026 at 4:00 AM 22 replies 520 viewsPage 2 of 5
Dr.NateNeph
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May 19, 2026 at 5:06 AM#6

The figures, for anyone assembling their own picture. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

30 0JakeSmashed95, NauseaFreeNow, SteveThurs and 27 others
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AussieAnna
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May 19, 2026 at 5:32 AM#7

One thing that is still open after Dr.NephBHM_UK’s answer:

What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?

29 24HPLC_Greg, LibrarianMeg, bri_stats and 26 others
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TinaHashiRN
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May 19, 2026 at 5:57 AM#8
Dr.NateNeph said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Coming at Dr.NateNeph’s question from a different direction. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

28 23Dr.Martinez, mike_mod, SarahChen_PharmD and 25 others
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A1cHero_PHX
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May 19, 2026 at 6:23 AM#9

OP back with an update, since a thread like this is useless without one.

Following this thread I went back and re-read the extension data properly. The point about trough rather than peak explains the pattern I was seeing on day six, which I had been blaming on the vial.

27 22chris_chi24, tampaLisa73, KarenAZ_mom and 24 others
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fiona_glasgow
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May 19, 2026 at 8:26 AM#10
TinaHashiRN said:
Steady state is the thing most people miss.

No disagreement with TinaHashiRN. One condition attached. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.

15 13NeuroNate, JessicaH_TX, KevinCompounds and 12 others
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