CagriSema for Diabetes: What the Evidence Shows
What human and animal studies show about CagriSema for diabetes, how strong that evidence is, and what is still unproven.
- Strongest evidence
- Human RCT
- Human studies
- 5
- with an outcome for diabetes, in our evidence file (PubMed search, 2 Oct 2026)
- Animal studies
- None found
- with an outcome for diabetes, in our evidence file (PubMed search, 2 Oct 2026)
- Studies we summarised
- 6
- with an outcome for diabetes
Evidence for diabetes
Each row is an outcome related to diabetes from a published study, strongest design first. Animal and cell results are labelled and are not human results. User reports are not counted as evidence here.
| Outcome | Result | Study type | Source |
|---|---|---|---|
| HbA1c at week 40 (primary) | HbA1c changed by -1·8 percentage points (2·4 mg each) and -1·5 (1·0 mg each) versus -0·1 with placebo at 40 weeks. | Human RCTn = 189 | The lancet. Diabetes & endocrinology 2026, PMID 42251860 |
| Body weight at week 40 | Body weight changed by -13·8% with CagriSema (2·4 mg each) versus -1·4% with placebo. | Human RCTn = 189 | The lancet. Diabetes & endocrinology 2026, PMID 42251860 |
| HbA1c vs semaglutide (primary) | HbA1c fell by -1·91 percentage points with CagriSema versus -1·75 with semaglutide 2·4 mg (difference -0·16). | Human RCTn = 2713 | The lancet. Diabetes & endocrinology 2026, PMID 42251859 |
| HbA1c at week 40 (primary) | HbA1c fell by -2·33% (2·4 mg each) and -2·10% (1·0 mg each) versus -0·66% with placebo at week 40 as add-on to basal insulin. | Human RCTn = 274 | Lancet 2026, PMID 42251856 |
| Body weight | CagriSema provided body weight reductions of 10-12%. | Human RCTn = 274 | Lancet 2026, PMID 42251856 |
| Body weight at week 68 (primary) | Body weight changed by -13.7% with CagriSema versus -3.4% with placebo at week 68 (difference -10.4 percentage points). | Human RCTn = 1206 | The New England journal of medicine 2025, PMID 40544432 |
| HbA1c of 6.5% or less | 73.5% reached a glycated hemoglobin level of 6.5% or less with CagriSema versus 15.9% with placebo. | Human RCTn = 1206 | The New England journal of medicine 2025, PMID 40544432 |
| HbA1c at week 32 (primary) | HbA1c changed by -2·2 percentage points with CagriSema, -1·8 with semaglutide and -0·9 with cagrilintide; the difference was significant versus cagrilintide but not versus semaglutide. | Human RCTn = 92 | Lancet 2023, PMID 37364590 |
| Body weight at week 32 | Body weight changed by -15·6% with CagriSema, -5·1% with semaglutide and -8·1% with cagrilintide at week 32. | Human RCTn = 92 | Lancet 2023, PMID 37364590 |
| Weight, waist, blood pressure and HbA1c | Versus placebo, CagriSema reduced body weight by a mean difference of -5.98% (-4.68 kg) and waist circumference by -10.91 cm, with reductions in systolic blood pressure and HbA1c. | Meta-analysisn = 5425 | Annals of medicine and surgery 2026, PMID 42583410 |
CagriSema and diabetes are not in our PubMed count ledger yet; the rows above come from our evidence file (PubMed search, 2 Oct 2026). Grades follow our .
How strong is it?
A human randomized trial outweighs any number of animal studies. Animal and cell results show a mechanism worth testing, not that it works in people.
What diabetes is
MedlinePlus describes diabetes as a disease in which blood glucose levels are too high.[7]
HbA1c results in people with type 2 diabetes
In the REIMAGINE 1 trial, adults whose diabetes was inadequately controlled on diet and exercise had an HbA1c fall of 1.8 percentage points with CagriSema (2.4 mg each) over 40 weeks, against 0.1 with placebo.[1]
REIMAGINE 2 compared the combination with semaglutide 2.4 mg in people on metformin, and found a small extra HbA1c fall of 0.16 percentage points for the combination.[2]
REIMAGINE 3 tested the combination as an add-on to basal insulin and reported HbA1c reductions of 2.33% and 2.10% at both dose levels, against 0.66% with placebo.[3]
In the REDEFINE 2 trial in adults with obesity and type 2 diabetes, 73.5% of those on the combination reached an HbA1c of 6.5% or less, compared with 15.9% on placebo.[4]
The phase 2 trial in type 2 diabetes found CagriSema's HbA1c change of -2.2 percentage points larger than the cagrilintide-alone arm.[5]
What the registered trials list as outcomes
The phase 2 record NCT04982575 lists change in HbA1c against semaglutide plus placebo as its primary measure, at week 32.[8]
The REDEFINE 2 record NCT05394519 registers change in HbA1c over 68 weeks as an outcome.[9]
Hypoglycaemia in the diabetes trials
The insulin add-on trial reported that no severe hypoglycaemia occurred.[3]
Other peptides people research for diabetes
All peptides for diabetes, comparedCommon questions
Does CagriSema help with diabetes?
The strongest study we summarise for diabetes is human rct evidence, across 6 studies with an outcome for diabetes. A trial result is not an approval; see the legal status.
Is CagriSema approved for diabetes?
No. CagriSema is not FDA approved for any use, including diabetes.
What is the best peptide for diabetes?
There is no single answer. Our diabetes overview compares each candidate by evidence grade and legal status rather than by popularity.
Is CagriSema being tested for type 2 diabetes?
Yes: the REIMAGINE phase 3 programme studies it in type 2 diabetes, including on diet and exercise alone and on top of metformin.[2]
Does CagriSema beat semaglutide for blood sugar?
In REIMAGINE 2 the authors concluded that the combination at 2.4 mg each was superior to semaglutide 2.4 mg in reducing HbA1c.[2]
More on CagriSema
Sources
- 1Efficacy and safety of once-weekly cagrilintide-semaglutide (CagriSema) in adults with type 2 diabetes inadequately controlled on diet and exercise (REIMAGINE 1): a randomised, double-blind, placebo-controlled, phase 3a study.The lancet. Diabetes & endocrinology · 2026PMID 42251860Accessed 2 Oct 2026
- 2Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2): a double-blind, randomised, controlled, phase 3 study.The lancet. Diabetes & endocrinology · 2026PMID 42251859Accessed 2 Oct 2026
- 3Cagrilintide-semaglutide (CagriSema) as an add-on to basal insulin in adults with type 2 diabetes (REIMAGINE 3): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study.Lancet (London, England) · 2026PMID 42251856Accessed 2 Oct 2026
- 4Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.The New England journal of medicine · 2025PMID 40544432Accessed 2 Oct 2026
- 5Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial.Lancet (London, England) · 2023PMID 37364590Accessed 2 Oct 2026
- 6Amylin-based obesity therapy: a meta-analysis of Cagrilintide and CagriSema versus placebo.Annals of medicine and surgery (2012) · 2026PMID 42583410Accessed 2 Oct 2026
- 7Official web pageOfficial web page · web page
- 8Efficacy and Safety of Co-administration of Cagrilintide s.c. 2.4 mg and Semaglutide s.c. 2.4 mg Once Weekly in Subjects With Type 2 DiabetesClinicalTrials.gov (U.S. National Library of Medicine) · 2021clinicaltrials.govAccessed 2 Oct 2026
- 9Efficacy and Safety of Cagrilintide s.c. 2.4 mg in Combination With Semaglutide s.c. 2.4 mg (CagriSema s.c. 2.4 mg/2.4 mg) Once-weekly in Participants With Overweight or Obesity and Type 2 DiabetesClinicalTrials.gov (U.S. National Library of Medicine) · 2022clinicaltrials.govAccessed 2 Oct 2026
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