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Semaglutides introduction of a fatty acid side chain at position 26 Lys allows reversible binding to plasma albumin and reduces renal clearance, and substitution of amino acids at positions 8 and 34 with Aib and Arg avoids its degradation by DPP-4 and prevents fatty acid binding at the wrong site, resulting in a once-weekly dosing (Lau et al., 2015

Clinical trials show oral semaglutide produces 10-15% weight loss, compared to 15-22% for the same dose injected, a meaningful difference over a year of treatment

DME appears as loss of foveal contour, and cystoid macular edema, as well as neurosensory detachment in the foveas center

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