Evidence map›GLP-1 receptor agonists × body weight & composition›PMID 31897524›Full record

Trial reportDiabetologia2020

Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial.

Rory J McCrimmon, Andrei-Mircea Catarig, Juan P Frias, Nanna L Lausvig, Carel W le Roux, Desirée Thielke, Ildiko Lingvay

Registry-linked trialOpen access · hybridFull text readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetologia, 2020. The graph read 1 number from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. It reports registered trial NCT03136484. Cited by 94 papers, 13 of them syntheses that pooled it.

1number the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 13 pooled it
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Body weight & compositioncomparator not stated · t2dfeeds 2 cells of the map
Δ -0.79-2.10 to 0.51
Total fat mass (baseline 33.2 kg) was reduced by 3.4 kg and 2.6 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: -0.79 [95% CI -2.10, 0.51]).
FeedsSGLT2 inhibitors×body weight & compositionGLP-1 receptor agonists×body weight & composition

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×body weight & composition

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 83 favour the treatment, 15 find no difference, 11 favour the comparator.

Belief with this paper
0.90replicated · 64 families support, 7 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT012722193,731 enrolled · 2011
Δ -5.39-5.82 to -4.95
Coadministered Cagrilintide and Semaglutide in Adults with Overweight …PMID 40544433 · 3,400 enrolled · 2022
Δ -17.3-18.1 to -16.6
NCT017204463,297 enrolled · 2013
Δ -2.95-3.47 to -2.44
NCT035489351,961 enrolled · 2018
Δ -12.4-13.4 to -11.5
NCT039879191,879 enrolled · 2019
Δ -1.70-2.60 to -0.70
NCT026078651,864 enrolled · 2016
Δ -2.50-3.00 to -2.00
NCT056467061,407 enrolled · 2023
Δ -14.8-16.2 to -13.4
NCT018365231,398 enrolled · 2013
Δ -4.90-5.65 to -4.16
NCT035527571,210 enrolled · 2018
Δ -6.21-7.28 to -5.15
NCT007344741,202 enrolled · 2008
Δ -1.50-2.08 to -0.92
Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type…PMID 40544432 · 1,200 enrolled · 2023
Δ -10.4-11.2 to -9.50
NCT020581471,170 enrolled · 2014
Δ 14.38.37 to 20.3

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

SGLT2 inhibitors×body weight & composition

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 62 favour the treatment, 9 find no difference, 2 favour the comparator.

Belief with this paper
0.98established · 50 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT010326294,330 enrolled · 2009
Δ -2.96-3.47 to -2.45
NCT010956661,484 enrolled · 2010
Δ -1.10-1.65 to -0.56
NCT009688121,452 enrolled · 2009
Δ -5.20-5.70 to -4.70
NCT017190031,413 enrolled · 2012
Adjusted mean -2.50-3.33 to -1.68
NCT011066771,284 enrolled · 2010
Δ -2.40-3.00 to -1.80
NCT016060071,282 enrolled · 2012
Δ -2.05-2.73 to -1.37
NCT006732311,240 enrolled · 2008
Δ -1.00-1.50 to -0.49
NCT020991101,233 enrolled · 2014
Δ -1.85-2.48 to -1.22
NCT006609071,217 enrolled · 2008
Δ -4.65-5.14 to -4.17
NCT018093271,186 enrolled · 2013
Δ -0.90-1.60 to -0.20
NCT010956531,179 enrolled · 2010
Δ -1.37-2.01 to -0.73
NCT008598981,093 enrolled · 2009
Δ -1.97-2.64 to -1.30

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03136484 phase3completed

Efficacy and Safety of Semaglutide Versus Canagliflozin as add-on to Metformin in Subjects With Type 2 Diabetes

Ran2017Enrolled788Registered outcomes61Posted comparisons2ConditionsDiabetes, Diabetes Mellitus, Type 2ArmsCanagliflozin, Placebo (canagliflozin), Placebo (semaglutide), semaglutide
PMID 31540867other papers from this trial
Open the trial in the graph
5 · Its place in the literature

Who cites it

94 citing papers in PubMed, 13 syntheses or guidelines pooled it, 141 citations in OpenAlex.

  1. Pooled it
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  3. A Systematic Review and Meta-Analysis of Semaglutide Effects on Adipose Tissue and Emerging Effects on Brain and Cognition.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
    Pooled it
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  5. Efficacy of Weight-Lowering Agents on Fat Distribution: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
    Pooled it
  6. Effects of GLP-1 Receptor Agonists on Muscle Mass, Strength, and Quality in MASLD: A Systematic Review.Liver international : official journal of the International Association for the Study of the Liver · 2026
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  17. Insulin Glargine is More Suitable Than Exenatide in Preventing Muscle Loss in Non-Obese Type 2 Diabetic Patients with NAFLD.Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association · 2023
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34 more citing papers are in PubMed but not listed here.

6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

7 authors at 5 institutions in 4 countries.

Rory J McCrimmonSchool of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK. r.mccrimmon@dundee.ac.uk.
Andrei-Mircea CatarigNovo Nordisk A/S, Vandtårnsvej, Søborg, Denmark.
Juan P FriasNational Research Institute, Los Angeles, CA, USA.
Nanna L LausvigNovo Nordisk A/S, Vandtårnsvej, Søborg, Denmark.
Carel W le RouxDiabetes Complications Research Centre, University College Dublin, Dublin, Ireland.
Desirée ThielkeNovo Nordisk A/S, Vandtårnsvej, Søborg, Denmark.
Ildiko LingvayDepartment of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
Novo Nordisk (Denmark) · DKNational Research Institute · USSouthwestern Medical Center · USUniversity College Dublin · IEUniversity of Dundee · GB

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aims/hypothesisIntra-abdominal or visceral obesity is associated with insulin resistance and an increased risk for cardiovascular disease. This study aimed to compare the effects of semaglutide 1.0 mg and canagliflozin 300 mg on body composition in a subset of participants from the SUSTAIN 8 Phase IIIB, randomised double-blind trial who underwent whole-body dual-energy x-ray absorptiometry (DXA) scanning.

methodsAdults (age ≥18 years) with type 2 diabetes, HbA

resultsA subset of 178 participants (semaglutide, n = 88; canagliflozin, n = 90) underwent DXA scanning at screening and were randomised into the substudy. Of these, 114 (semaglutide, n = 53; canagliflozin, n = 61) participants had observed end-of-treatment data included in the confirmatory efficacy analysis. Of the 178 participants in the substudy, numerical improvements in body composition (including fat mass, lean mass and visceral fat mass) were observed after 52 weeks with both treatments. Total fat mass (baseline 33.2 kg) was reduced by 3.4 kg and 2.6 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: -0.79 [95% CI -2.10, 0.51]). Although total lean mass (baseline 51.3 kg) was also reduced by 2.3 kg and 1.5 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: -0.78 [-1.61, 0.04]), the proportion of lean mass (baseline 59.4%) increased by 1.2%- and 1.1%-point, respectively (estimated treatment difference 0.14 [-0.89, 1.17]). Changes in visceral fat mass and overall changes in body composition (assessed by the fat to lean mass ratio) were comparable between the two treatment groups. CONCLUSIONS/

interpretationIn individuals with uncontrolled type 2 diabetes on stable-dose metformin therapy, the changes in body composition with semaglutide and canagliflozin were not significantly different. Although numerical improvements in body composition were observed following treatment in both treatment arms, the specific impact of both treatments on body composition in the absence of a placebo arm is speculative at this stage.

trial registrationClinicalTrials.gov NCT03136484.

fundingThis trial was supported by Novo Nordisk A/S, Denmark.

Indexed as

AgedBlood GlucoseBody CompositionCanagliflozinDiabetes Mellitus, Type 2Double-Blind MethodDrug Administration RoutesDrug Administration ScheduleDrug Therapy, CombinationFemaleGlucagon-Like PeptidesGlycated HemoglobinHumansMaleMetforminMiddle AgedBlood GlucoseCanagliflozinGlucagon-Like PeptidesGlycated Hemoglobinhemoglobin A1c protein, humanMetforminSemaglutideBody compositionCanagliflozinFat massGlucagon-like peptide receptor agonistsRandomised controlled trialSemaglutideType 2 diabetesWeight

Identifiers

PMID31897524
PMCPMC6997246
OpenAlexW2997634477

What Socratic holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.