A Research Study to Look Into How Semaglutide, Together With a Lower Dose of Insulin Glargine, Compares to a Higher Dose of Insulin Glargine Alone in People With Type 2 Diabetes (SUSTAIN OPTIMIZE)

NCT ID: NCT05514535

Last Updated: 2025-11-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

568 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-29

Study Completion Date

2025-04-09

Brief Summary

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This study compares semaglutide, together with a lower dose of insulin glargine, to a higher dose of insulin glargine in participants with type 2 diabetes. The study looks at how well the study medicines control blood glucose levels. Participants will either get semaglutide together with a lower dose of insulin glargine or a higher dose of insulin glargine. The study will last for about 47 weeks (approximately 11 months). Participants will have 9 clinic visits, 15 phone/video calls and 1 home visit. Participants will be asked to wear a sensor that measures their blood sugar all the time in 2 periods of 10 days during the study.

Detailed Description

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Conditions

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Diabetes Mellitus, Type 2 Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Insuline glargine U100 (reduced) + semaglutide

Participants will initially receive 0.25 milligrams (mg) once-weekly semaglutide subcutaneously (s.c.) and the dose will be gradually escalated to 2 mg as an add-on to dose-reduced insulin glargine s.c. given once-daily. Insulin glargine U100 will be reduced by 10 U at the initiation of semaglutide and then again at each semaglutide dose escalation. Insulin glargine dose will be adjusted based on the mean of three pre-breakfast self-measured plasma glucose (SMPG) values (target SMPG: 4.4-7.2 millimoles per litre (mmol/L)).

Group Type EXPERIMENTAL

Semaglutide

Intervention Type DRUG

Participants will receive once-weekly semaglutide s.c. for 40 weeks. Semaglutide 0.25 mg will be given at week 0 and then the dose will be escalated at weeks 4, 8 and 12 to 0.5 mg, 1 mg, 2 mg respectively.

Insuline glargine U100 (reduced)

Intervention Type DRUG

Participants will receive insulin glargine U100 s.c. once-daily. Insulin glargine dose will be reduced by 10 U at initiation of semaglutide and then again at each semaglutide dose escalation up to 40 weeks. The dose will be adjusted based on the mean of three pre-breakfast SMPG values (target SMPG: 4.4-7.2 mmol/L).

Insuline glargine U100 (titrated)

Participants will receive titrated insuline glargine U100 s.c. once-daily. Insulin glargine U100 dose will be adjusted based on the mean of three pre-breakfast SMPG values (target SMPG: 4.4-7.2 mmol/L).

Group Type ACTIVE_COMPARATOR

Insuline glargine U100 (titrated)

Intervention Type DRUG

Participants will receive titrated insulin glargine U100 s.c. once-daily up to 40 weeks. The dose will be adjusted based on the mean of three pre-breakfast SMPG values (target SMPG: 4.4-7.2 mmol/L).

Interventions

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Semaglutide

Participants will receive once-weekly semaglutide s.c. for 40 weeks. Semaglutide 0.25 mg will be given at week 0 and then the dose will be escalated at weeks 4, 8 and 12 to 0.5 mg, 1 mg, 2 mg respectively.

Intervention Type DRUG

Insuline glargine U100 (reduced)

Participants will receive insulin glargine U100 s.c. once-daily. Insulin glargine dose will be reduced by 10 U at initiation of semaglutide and then again at each semaglutide dose escalation up to 40 weeks. The dose will be adjusted based on the mean of three pre-breakfast SMPG values (target SMPG: 4.4-7.2 mmol/L).

Intervention Type DRUG

Insuline glargine U100 (titrated)

Participants will receive titrated insulin glargine U100 s.c. once-daily up to 40 weeks. The dose will be adjusted based on the mean of three pre-breakfast SMPG values (target SMPG: 4.4-7.2 mmol/L).

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with Type 2 Diabetes Mellitus (T2D) mellitus greater than or equal to (\>=) 180 days before screening.
* Glycated haemoglobin (HbA1c) of 7-10 percentage \[(53-86 millimoles per mole (mmol/mol)\] (both inclusive) as assessed by central laboratory on the day of screening.
* Body mass index (BMI) greater than or equal to (\>=) 25 kilograms per meter square (kg/m\^2) on the day of screening.
* Stable daily dose(s) greater than or equal to (\>=) 90 days before screening of any of the following anti-diabetic drugs or combination regimens:
* Any metformin formulations greater than or equal to (\>=) 1500 milligrams (mg) or maximum tolerated or effective dose.
* Any metformin combination formulation greater than or equal to (\>=) 1500 mg or maximum tolerated or effective dose.

The treatment can be with or without sodium glucose cotransporter 2 (SGLT-2) inhibitors.

• Treated with a once daily basal insulin (e.g. insulin glargine Unit 100 or U300, neutral protamine hagedorn (NPH) insulin, insulin detemir, insulin degludec) less than or equal to (\<=) 40 units/day (U/day) for greater than or equal to (\>=) 90 days before screening. Short-term bolus insulin treatment for a maximum of 14 days before screening is allowed.

Exclusion Criteria

* Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days before screening or in the period between screening and randomisation. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
* Potentially missed diagnosis of Type 1 diabetes (T1D) or latent autoimmune diabetes in adults (LADA) verified by C-peptide less than 0.26 nanomoles per litre (nmol/L) (or 260 picomoles per liter \[pmol/L\] \[0.78 nanograms per millilitre {ng/mL}\]) or antibodies to glutamic acid decarboxylase (anti-GAD) greater than 5 units/millilitre, as measured by the central laboratory at screening.
* Presence or history of pancreatitis (acute or chronic).
* Renal impairment measured as estimated Glomerular Filtration Rate (eGFR) value of less than 30 millilitre per minute per 1.73 meter square at screening as defined by Kidney Disease: Improving Global Outcomes (KDIGO) 2012 classification.
* Any episodes of diabetic ketoacidosis within 90 days before screening.
* Known hypoglycaemic unawareness as indicated by the investigator according to Clarke's questionnaire question 8.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Novo Nordisk A/S

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Transparency (dept. 2834)

Role: STUDY_DIRECTOR

Novo Nordisk A/S

Locations

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MediTask, s.r.o

Bratislava, , Slovakia

Site Status

MEDISPEKTRUM s.r.o.

Bratislava, , Slovakia

Site Status

Diabetologicka ambulancia DIA-MAX s.r.o.

Levice, , Slovakia

Site Status

IN-DIA s.r.o.

Lučenec, , Slovakia

Site Status

FUNKYSTUFF s.r.o

Nové Zámky, , Slovakia

Site Status

Diakom, spol. s r.o.

Poprad, , Slovakia

Site Status

DIALIPID, s.r.o.

Prešov, , Slovakia

Site Status

Tatratrial s.r.o.

Rožňava, , Slovakia

Site Status

BENROD s.r.o.

Štúrovo, , Slovakia

Site Status

Diabetes Care Centre & CDE Centre

Benoni, Gauteng, South Africa

Site Status

East Rand Physicians

Benoni, Gauteng, South Africa

Site Status

East Rand Physicians

Johannesburg, Gauteng, South Africa

Site Status

Centre for Diabetes

Johannesburg, Gauteng, South Africa

Site Status

Dr J Reddy

Durban, KwaZulu-Natal, South Africa

Site Status

Dr Pillay's Rooms

Durban, KwaZulu-Natal, South Africa

Site Status

Dr T Padayachee

eMkhomazi, KwaZulu-Natal, South Africa

Site Status

Centro Periférico de Especialidades Bola Azul

Almería, , Spain

Site Status

ABS La Roca del Vallés_Endocrinología

La Roca Del Vallés, , Spain

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ABS La Roca del Vallés

La Roca Del Vallés, , Spain

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Hospital Infanta Leonor

Madrid, , Spain

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Hospital Son Espases

Palma de Mallorca, , Spain

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Hospital Infanta Luisa

Seville, , Spain

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Kharkiv Regional Clinical Hospital - Endocrinology department

Kharkiv, , Ukraine

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Khmelnytskyi Regional Hospital - Endocrinology department

Khmelnytskyi, , Ukraine

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Ternopil Central District Hospital - Outpatient department

Ternopil, , Ukraine

Site Status

Medical centre"Elitmedservis"LLC

Zaporizhzhia, , Ukraine

Site Status

Lenzmeier Fam Med CCT Research

Glendale, Arizona, United States

Site Status

San Fernando Valley Hlth Inst, LLC

Canoga Park, California, United States

Site Status

John Muir Physicians Network

Concord, California, United States

Site Status

Valley Research

Fresno, California, United States

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Providence Medical Foundation

Fullerton, California, United States

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Velocity Clinical Research Huntington Park

Huntington Park, California, United States

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Velocity Clin Res San Diego

La Mesa, California, United States

Site Status

First Valley Medical Group

Lancaster, California, United States

Site Status

Loma Linda Univ Hlth Cr Endo

Loma Linda, California, United States

Site Status

Downtown LA Res Ctr. Inc.

Los Angeles, California, United States

Site Status

Velocity Clin Res Los Angeles

Los Angeles, California, United States

Site Status

Valley Clinical Trials, Inc.

Northridge, California, United States

Site Status

Wetlin Research Associates, Inc.

San Diego, California, United States

Site Status

Encore Medical Research LLC

Hollywood, Florida, United States

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Northeast Res Inst. Inc.

Jacksonville, Florida, United States

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Jacksonville Ctr For Clin Res

Jacksonville, Florida, United States

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New Horizon Research Center

Miami, Florida, United States

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Elite Research Center

Miami, Florida, United States

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Reyes Clinical Research, Inc

Miami, Florida, United States

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International Research Associates, LLC_Miami

Miami, Florida, United States

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Suncoast Clin Res Port Richey

New Port Richey, Florida, United States

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Suncoast Clinical Research, Inc._New Port Richey

New Port Richey, Florida, United States

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Renstar Medical Research

Ocala, Florida, United States

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CVS Store Number: 7689

Atlanta, Georgia, United States

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Coastal Heritage Clinical Research

Hinesville, Georgia, United States

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Endocrine Research Solutions

Roswell, Georgia, United States

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CVS Store Number: 05520

Savannah, Georgia, United States

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Cedar-Crosse Research Center

Chicago, Illinois, United States

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Brengle Family Medicine

Indianapolis, Indiana, United States

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West Broadway Clinic

Council Bluffs, Iowa, United States

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Iowa Diab & Endo Res Center

West Des Moines, Iowa, United States

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Iowa Diab & Endo Res Center

West Des Moines, Iowa, United States

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Cotton O'Neil Diab & Endo Ctr

Topeka, Kansas, United States

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The Research Group of Lexington LLC

Lexington, Kentucky, United States

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AMR New Orleans

New Orleans, Louisiana, United States

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Ileana J. Tandron, MD APMC (a private medical office)

Slidell, Louisiana, United States

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MedStar Hlth Res Institute

Hyattsville, Maryland, United States

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Endo And Metab Cons

Rockville, Maryland, United States

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Joslin Diabetes Center

Boston, Massachusetts, United States

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Northern Pines Hlth Ctr, PC

Buckley, Michigan, United States

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Elite Research Center

Flint, Michigan, United States

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Arcturus HC PLC Troy Med Res

Troy, Michigan, United States

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StudyMetrix Research LLC

City of Saint Peters, Missouri, United States

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Mercury Str Med Grp, PLLC

Butte, Montana, United States

Site Status

Palm Research Center Inc-Vegas

Las Vegas, Nevada, United States

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Southern New Hampshire Diabetes and Endocrinology

Nashua, New Hampshire, United States

Site Status

AMC Community Endocrinology

Albany, New York, United States

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Mid Hudson Med Res-New Windsor

New Windsor, New York, United States

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Carteret Medical Group

Morehead City, North Carolina, United States

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Lucas Research Inc.

Morehead City, North Carolina, United States

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Lillestol Research LLC

Fargo, North Dakota, United States

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Velocity Clin Res Cleveland

Beachwood, Ohio, United States

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Diab & Endo Assoc of Stark Co

Canton, Ohio, United States

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Advanced Med Res Maumee

Maumee, Ohio, United States

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University of Toledo Medical Center

Toledo, Ohio, United States

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University of Toledo_Toledo

Toledo, Ohio, United States

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Thomas Jefferson University

Philadelphia, Pennsylvania, United States

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Chattanooga Medical Research, LLC

Chattanooga, Tennessee, United States

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Holston Medical Group

Kingsport, Tennessee, United States

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Accellacare US Inc., d/b/a Accellacare of Knoxville

Knoxville, Tennessee, United States

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Amarillo Med Spec LLP

Amarillo, Texas, United States

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Arlington Family Res. Ctr Inc

Arlington, Texas, United States

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Thyroid Endocrinology & Diabetes PA

Dallas, Texas, United States

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Velocity Clinical Res-Dallas

Dallas, Texas, United States

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Diabetes and Thyroid Ctr of FW

Fort Worth, Texas, United States

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San Antonio Prem Int Med

San Antonio, Texas, United States

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Diabetes Glandular Diseases Clinic

San Antonio, Texas, United States

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VIP Trials

San Antonio, Texas, United States

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Diabetes Glandular Diseases Clinic

San Antonio, Texas, United States

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Consano Clinical Research, LLC

Shavano Park, Texas, United States

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Hillcrest Family Health Center

Waco, Texas, United States

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Olympus Family Medicine

Salt Lake City, Utah, United States

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Chrysalis Clinical Research

St. George, Utah, United States

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Virginia Endo Res, LLC

Chesapeake, Virginia, United States

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CVS Store Number: 01396

Reston, Virginia, United States

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CVS Store Number: 1537

Richmond, Virginia, United States

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Amherst Family Practice P.C.

Winchester, Virginia, United States

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WVU Medicine

Morgantown, West Virginia, United States

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EDUMED s.r.o.

Náchod, , Czechia

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Diahelp - diabetologie

Pardubice, , Czechia

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MUDr. Jitka Zemanova - diabetologie a interna, s.r.o.

Plzen - Vychodni Predmesti, , Czechia

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Diabet2 s.r.o.

Prague, , Czechia

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MUDr. Michala Pelikanova

Prague, , Czechia

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ResTrial s.r.o.

Prague, , Czechia

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University Hospital of Athens ATTIKON

Athens, Attica, Greece

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University Hospital of Alexandroupolis

Alexandroupoli, , Greece

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"Laiko" General Hospital of Athens

Athens, , Greece

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Alexandra General Hospital, Therapeutic Clinic

Athens, , Greece

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Alexandra General Hospital, Therapeutic Clinic

Athens, , Greece

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General Hospital of Nikaia

Nikaia, , Greece

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Tzaneio General Hospital of Piraeus

Piraeus, , Greece

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AHEPA General University Hospital

Thessaloniki, , Greece

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EUROMEDICA Gen Clinic The/ki, Endocrin,Metabolism,Diabetes

Thessaloniki, , Greece

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"Thermi" Private Hosital

Thessaloniki, , Greece

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General Hospital of Thessaloniki "G.Papanikolaou"

Thessaloniki, , Greece

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"Thermi" Private Hosital

Thessaloniki, , Greece

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A.O.U. Università Studi della Campania "Luigi Vanvitelli"

Napoli, Campania, Italy

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Ospedale Santa Maria Goretti - UOD Diabetologia

Latina, LT, Italy

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Azienda Unita' Sanitaria Locale Toscana Nord Ovest - Cittadella della Salute Campo di Marte

Lucca, LU, Italy

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Istituto Scientifico San Raffaele

Milan, MI, Italy

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Azienda Ospedaliera di Perugia;Ospedale S. Maria della Misericordia

Perugia, Umbria, Italy

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Azienda Ospedaliera Papa Giovanni XXIII

Bergamo, , Italy

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Policlinico Mater Domini Università di Catanzaro

Catanzaro, , Italy

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ASST degli Spedali Civili di Brescia-Presidio Ospedaliero di Montichiari

Montichiari, , Italy

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A.O.U. Università Studi della Campania "Luigi Vanvitelli"

Napoli, , Italy

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Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Dipartimento di scienze Mediche e Chirurgiche

Rome, , Italy

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Unidade Local De Saude De Matosinhos E.P.E.

Senhora Da Hora, Matosinhos, Matosinhos, Portugal

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Unidade Local De Saude De Almada-Seixal E.P.E. - Hospital Garcia de Orta

Almada, , Portugal

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Unidade Local De Saude Da Regiao De Aveiro E.P.E.

Aveiro, , Portugal

Site Status

Unidade de Local de Saúde de Braga

Braga, , Portugal

Site Status

Unidade Local De Saude Do Oeste E.P.E.

Caldas da Rainha, , Portugal

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Unidade Local De Saude Da Regiao De Leiria E.P.E.- Hospital de Santo André

Leiria, , Portugal

Site Status

Unidade Local de Saúde de São José EPE - Hospital Curry Cabral

Lisbon, , Portugal

Site Status

Unidade Local De Saude De Lisboa Ocidental E.P.E. - Hospital Egas Moniz

Lisbon, , Portugal

Site Status

Unidade Local de Saúde do Alto Minho E.P.E. - Viana do Castelo

Viana do Castelo, , Portugal

Site Status

SC Grand Med SRL

Oradea, Bihor County, Romania

Site Status

Spitalul Judetean de Urgenta Targoviste

Târgovişte, Dâmbovița County, Romania

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CMI Dr Pop Lavinia

Baia Mare, Maramureş, Romania

Site Status

Novus Medical Clinica SRL

Ploieşti, Prahova, Romania

Site Status

Centrul Medical Sfantul Stefan

Timișoara, Timiș County, Romania

Site Status

Centrul Medical de Diagnostic si Tratament Ambulatoriu Neomed

Brasov, , Romania

Site Status

Clinica Grivitei 224 S.R.L.

Brăila, , Romania

Site Status

Diabs&Nutricare Srl

Bucharest, , Romania

Site Status

Clinic of Diabetes Constanta

Constanța, , Romania

Site Status

Clinical Emergency Sf. Apostol Andrei Hospital

Galati, , Romania

Site Status

SC Consultmed SRL

Iași, , Romania

Site Status

Medical Practice SRL

Oradea, , Romania

Site Status

S.C. Dianutrilife Medica S.R.L.

Ploieşti, , Romania

Site Status

Clinica Korall S.R.L. Satu Mare

Satu Mare, , Romania

Site Status

Dentosim Queen Srl

Târgu Mureş, , Romania

Site Status

DIA - CLARUS s.r.o.

Bojnice, , Slovakia

Site Status

Countries

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United States Czechia Greece Italy Portugal Romania Slovakia South Africa Spain Ukraine

Other Identifiers

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U1111-1267-0312

Identifier Type: OTHER

Identifier Source: secondary_id

2021-004392-13

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

NN9535-4801

Identifier Type: -

Identifier Source: org_study_id

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