Oral GLP-1 news: that 25 mg A1c chart looks too clean?

I noticed the week-20 flattening too. The supplement lists GI dropout at 13.2% vs 6.8% placebo, which feels high for an oral arm.

Honestly, the part people forget is the titration artifact. The dose escalations all get front-loaded before week 12, so anything measured after that is basically comparing people at different points on the ramp.

Did they publish BMI subgroups? From what I see in clinic, plateaus on injectables land around week 18 to 22 regardless of arm. Curious whether that splits by BMI band.

Same plateau here. Around the 20-week mark the scale just quit moving — 29 lbs down, then six weeks of flat nothing. Labs kept improving the whole time though.

That’s the weird part — A1c and weight don’t move together. Mine went 7.1 to 5.8 while weight stalled for two months.

I pulled the supplement PDF last night. The flat stretch after week 20 isn’t pure titration; they also permitted rescue meds after week 24 in both arms, which blurs the between-group difference. And that 13.2% GI dropout figure is real, but most discontinuations happened during the 3 mg to 7 mg step, not later. That timing makes me less worried about durability and more curious whether the 25 mg benefit is worth the tolerability tradeoff. I want the GI adverse-event table by week. If that table shows most GI events were mild and early, the durability story looks very different to me.

Rescue meds are such a cop-out in these trials.

Worth knowing before you compare options: that 3 mg to 7 mg nausea window lines up exactly with the injectable pattern that keeps coming up in these threads.

If you go back through 47 weeks of logs, the A1c does the same boring flatline: 7.2 down to 5.9 by around week 24, then 5.8, 5.9, 5.9 at weeks 36, 42, and 47, while waist dropped another inch and a half and the scale only moved 6 lbs. That actually makes a flat tail read as less suspicious to me, not more — the early plunge looks like the fast stuff (water, inflammation, glucose finally getting under control), and the plateau is just the slower fat/insulin slog. The dropout rate is the part people forget, though: if the ones with rough GI leave early, the remaining mean can look weirdly tidy, so before anyone calls it durability you'd want the completer curve and how many needed rescue meds. Worth knowing before comparing options: did anyone track fasting glucose weekly during the flat stretch, or only A1c every 3 months?

Does anyone know if that oral arm’s A1c curve is completer-only? That’s my first question. If people dropped out for GI and got excluded, the flat post-week-20 stretch is survivorship, not durability. I’d want the ITT curve plus the missing-data sensitivity analysis before

Completer-only would explain the pretty curve; I just want the dropout reality too.

I track fasting glucose daily and A1c quarterly. Mine lagged about 8 weeks behind fasting; A1c often looks flat while fasting/weight still move. For that oral dataset, I’d want CGM time-in-range or fasting glucose trajectory, plus whether background meds changed. A1c alone can’t separate durability from hemoglobin turnover and weight-loss plateau. Did they publish TIR or rescue-med rates? That’s what I’d check before calling the curve real.

I want the timing of those GI dropouts, not just the total %. If most quit between weeks 4–8, that flat week-20+ A1c is mostly survivors; if they’re evenly spread, durability feels less fragile. I track side-effect days in a separate column from fasting glucose and weight because a rough gut week changes what I eat and skews my own trends. Did the release show a Kaplan-Meier discontinuation curve, or only the overall dropout percentage? That would tell me more than the A1c chart.

If that chart is just means, I’m not impressed yet. I want the 95% CI and the n at each visit. A flat week-20-to-52 mean can hide a shrinking denominator and huge variance. Also, was there a washout before the week-52 draw? I track weekly weights and quarterly A1c, and my own “plateau” turned out to be a boring month, not some new durability phase. Without CI + n, that curve is a marketing asset.

I track my symptoms in a note app, and my GI stuff was never linear—it flared more with late or heavier meals than with time on med. So I’d want to know if the oral trial standardized meal timing

same—my GI flares followed stress and sleep, not a tidy curve. I’d want the

one thing I haven’t seen asked: was the oral arm’s baseline A1c actually lower? If it started closer to 8 than 8.5, a flatter mean drop could partly be a ceiling effect, not durability. Also, was that flat stretch from the same people, or did completers’ averages hide the dropouts? I track with a CGM, and my “flat” weeks were usually just more consistent eating, not the med doing something different. Do they show baseline A1c and rescue-med use by arm? That would change how I read the chart.