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ForumsSemaglutide (Ozempic / Wegovy)A1C reduction on semaglutide: SUSTAIN program meta-analysis — anyone have experience? Page 2

A1C reduction on semaglutide: SUSTAIN program meta-analysis — anyone have experience?

BethLabQueen Tue, Nov 4, 2025 at 9:33 AM 11 replies 1,280 viewsPage 2 of 3
Dr.RaviCardio
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Nov 5, 2025 at 7:22 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.

6 1pete_manc_UK, anna.melb_AU, mark_tokyo and 3 others
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GraceAZ_72
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Nov 5, 2025 at 4:04 PM#7

A narrower follow-up, since the general answer is now clear:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

Last edited: Nov 5, 2025 at 8:04 PM
5 0CryptoCarl, MariaRD, AussieAnna and 2 others
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Dr.GastroMayo
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Nov 6, 2025 at 12:46 AM#8
Dr.RaviCardio 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…

There is a second half to this that has not been said yet. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

Last edited: Nov 6, 2025 at 5:46 AM
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BethLabQueen
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Nov 6, 2025 at 9:28 AM#9

Closing the loop on my own question.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.

3 23cory_ATX, lori_vegas, Dr.PulmRoch
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pete_nash
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Nov 8, 2025 at 3:15 AM#10
Dr.GastroMayo said:
The dose-response is real but shallow at the top.

Agreeing with Dr.GastroMayo, and the qualification matters more than the agreement. 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.

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