FDA-approved peptides for T2D
GLP-1 agonists (preferred for most patients)
- Semaglutide (Ozempic, Rybelsus oral)
- Tirzepatide (Mounjaro) — superior HbA1c reduction
- Dulaglutide (Trulicity)
- Liraglutide (Victoza)
- Exenatide (Byetta, Bydureon)
Insulin and analogs
- Basal: Glargine, Detemir, Degludec
- Rapid: Lispro, Aspart, Glulisine
- For T1D and advanced T2D
Amylin analogs
- Pramlintide (Symlin) — adjunct to insulin
Selection criteria
First-line in T2D after metformin: GLP-1 agonist for most patients. Tirzepatide produces best HbA1c reduction; semaglutide has strongest cardiovascular outcomes data (SELECT trial).
Best GLP-1 for diabetes?
Tirzepatide (superior HbA1c). Semaglutide for established CVD due to outcomes data.