| When to switch | What to do |
| Target HbA1c is not achieved because of: |
|
| Poor adherence | Switch to an OW GLP-1RA |
| Disease progression or lack of efficacy of the current GLP1-RA | Switch to an agent with proven better glycemic efficacy |
| The development of anti-drug antibodies | Switch to different types of GLP1-RA Switch to a human GLP-1 analogue |
| The need for additional weight loss | The most effective GLP1-RA is OW semaglutide. [3] |
| Increased CV risk in T2DM | [9] [11] [13] |
| Established CVD | Dulaglutide, liraglutide or OW semaglutide |
| Multiple CV risk factors | Dulaglutide |
| More advanced CKD status: eGFR < 30 mL/min/1.73 m2 | Switch to a dulaglutide, liraglutide or OW semaglutide [9] [10] [11] [12] [63] |
| Adverse effects | Switch to another GLP1-RA [44] |