I have type 2 diabetes. Are GLP-1 medicines for me?

Why does this matter so much in India?

About 101 million people in India had diabetes in 2021. That's about 1 in 9 adults.¹

The national ICMR-INDIAB study, run by the Indian Council of Medical Research, tested more than 1 lakh adults in 31 states and union territories.¹ It found diabetes in 11.4% of them, and prediabetes (sugar higher than normal, but not yet diabetes) in another 15.3%.¹

What is HbA1c, and how do I get it tested?

HbA1c is a common blood test that shows your average blood sugar over the last 2 to 3 months. It's the main number used to track type 2 diabetes, and most labs in India do it.

Sugar in your blood sticks to haemoglobin, the protein in red blood cells. The test measures how much of it has sugar attached, as a percentage. The more sugar in your blood over those months, the higher the number.¹⁵ A finger-prick test shows your sugar at one moment. HbA1c is closer to an average over months.² Your report may call it A1C or glycated haemoglobin. It's the same test.¹⁴

• No fasting needed. It's a normal blood draw, at any time of day.^14,19
• How often. With diabetes, Indian guidelines suggest every 3 to 6 months, more often when the number is off target or your medicines change.^3,4
• What it costs. On 5 Oct 2026, private lab chains listed it at ₹430 (Dr Lal PathLabs, Delhi), ₹640 (Metropolis, Delhi) and ₹672 (Thyrocare, list price; it often shows a lower offer price).^17,18,19 Prices vary by city.
• The ranges. Below 5.7% is normal, 5.7% to 6.4% is prediabetes, and 6.5% or above is the diabetes range.^3,14

What HbA1c should I aim for?

For most adults with type 2 diabetes, the target is an HbA1c below 7%. Your doctor may set a different one.

A lower target means less risk of long-term damage, but more risk of low sugar. That's why it differs from person to person.^2,3

What three guidelines say:

RSSDI is the Research Society for the Study of Diabetes in India. ESI is the Endocrine Society of India.³

How do they compare with metformin, and can I take both?

Metformin is usually the first tablet for type 2 diabetes. In a direct comparison, a weekly GLP-1 lowered HbA1c a little more than metformin. The two can also be taken together.

A fall in HbA1c of 1 point means, for example, going from 8% to 7%. The two trials below compared medicines with each other, not with a dummy treatment.

Average fall in HbA1c, in points:

These are averages from two separate trials with different people, so don't compare numbers across the two cards. The Ozempic label reports no new safety problems in 959 people who took it with metformin in trials.⁷

What if I also take insulin or a sulfonylurea?

Then your risk of low sugar (a hypo) goes up. Your doctor may lower your insulin or sulfonylurea dose when you start.

Sulfonylureas are older tablets such as glimepiride and gliclazide. They can cause hypos on their own.³ The Ozempic label warns that combining them can cause hypos, including severe ones.⁷ A lower sulfonylurea or insulin dose may reduce that risk.⁷ That's your doctor's call, so don't change doses yourself.

Signs of low sugar include:⁷

• dizziness, shaking or sweating
• hunger
• blurred vision
• a fast heartbeat
• confusion or drowsiness

What about my kidneys and eyes?

For kidneys, one large trial found fewer serious kidney problems on semaglutide in people who already had kidney disease. For eyes, tell your eye doctor you've started, especially if you have retinopathy (damage to the back of the eye from diabetes).

A large kidney trial followed 3,533 people who had type 2 diabetes and kidney disease, for about 3.4 years. Half took semaglutide (Ozempic) 1 mg a week, half a dummy injection.¹⁰

The researchers counted everyone who had any one of these:¹⁰

• kidney failure: needing dialysis or a transplant, or kidney function falling very low
• losing at least half of their kidney function
• dying from kidney or heart causes

Out of every 100 people, how many had one or more of these:

What this means. Semaglutide lowered the risk of these events by about a quarter (24%).¹⁰ Put simply: for every 22 people treated for about 3 years, one fewer person had kidney failure, a big loss of kidney function, or died from kidney or heart causes. The difference was clear enough that the trial was stopped early.¹⁰ This was in people who already had kidney disease, so it doesn't show the medicine protects healthy kidneys.

But vomiting or diarrhoea can dry you out, and that can damage the kidneys.⁷

Eyes. In a 2-year trial in people with type 2 diabetes, eye complications from retinopathy were more common on Ozempic than on a dummy injection. The gap was bigger in people who already had retinopathy.⁷

Out of every 100 people, how many had eye complications:

Bars for eyes are drawn on a scale up to 10 in 100.

Report any change in your vision.⁷

Will I lose as much weight as people without diabetes?

On average, people with diabetes lost less in trials. Two trials of semaglutide 2.4 mg, the weekly dose sold as Wegovy, each ran for 68 weeks (about 16 months).

Average share of body weight lost, and what that means for someone who starts at 90 kg (198 lb):

What this means. These are separate trials with different people, so the gap between them is a rough guide, not a direct comparison. They are averages too, so your own result may be higher or lower.

What to read next, in order

These four guides go deeper. Each one ends with a link to the next, so you can read them one after another.

1. 1Do I have obesity? What Indian BMI and waist numbers meanGuide 1 of 9UnderstandWhy Indians get diabetes at lower weights, and what BMI and waist mean for you.
2. 2What do GLP-1 medicines do?Guide 2 of 9UnderstandHow these medicines release insulin only when sugar is high.
3. 3Side effects and risksGuide 5 of 9DecideStomach effects, and the risks that matter more with diabetes.
4. 4Seeing a doctor, and the medicines in IndiaGuide 6 of 9Do it safelyBrands sold for diabetes in India, generics, recalls and monthly cost.