A once-a-day tablet, not an injection: what the new GLP-1 pill trial found
What happened
A trial of a new diabetes tablet was published in the journal Nature Medicine in October 2026. The drug is called safiglipron. During development it was known as HRS-7535. It is made by Jiangsu Hengrui Pharmaceuticals, a Chinese company. Safiglipron belongs to a family of medicines you have almost certainly heard about: GLP-1 receptor agonists. Semaglutide and tirzepatide are in the same family. Those are usually given as a weekly injection. Safiglipron is different in one important way. It is a small molecule, which means it can be made into a tablet and swallowed once a day. The trial was called OUTSTAND-1. It was a phase 3 study, which is the large, late stage of testing before a company applies for a licence. Here is how it was set up: - 284 adults with type 2 diabetes took part. - They were all managing their diabetes with diet and exercise alone. None were on glucose-lowering medicines. - Their average starting HbA1c, a long-term blood sugar measure, was 7.95%. - Half of them had been diagnosed within the last year and a half. - 33.1% were women. - They were randomly put into four groups: safiglipron 30mg, 60mg, 90mg, or a placebo tablet. - The main part ran for 32 weeks, followed by a 20-week extension in which everyone took the active drug. - It ran across 46 hospital sites in China. - It was double-blind, meaning neither the patients nor their doctors knew who was on the real tablet. The headline result was on the blood sugar measure. At the 90mg dose, HbA1c fell by 1.45 percentage points more than placebo, with a confidence range of 1.14 to 1.75. On the secondary measures, between 71.4% and 77.8% of people on safiglipron got their HbA1c below 7.0%, against 25.0% on placebo. Between 58.6% and 68.1% got to 6.5% or lower, against 16.7% on placebo. Weight change was much more modest: 0.65%, 2.23% and 3.56% below placebo across the three doses.
Why this matters
Two things make this interesting, and neither is the one that gets the most attention. The first is the form. Weekly injections work, but they are not for everyone. Some people are frightened of needles. Some struggle with the dexterity needed. Injectable GLP-1 medicines also need to be kept cool, which complicates travel, holidays and supply. A plain daily tablet avoids all of that. It can be posted. It sits in a kitchen cupboard. It fits into the same pill organiser as everything else. The second is who was studied. This trial was in people with early type 2 diabetes who were not yet on any diabetes medicine. That is a large group, and in the UK it is usually the point at which metformin is offered. So the question this trial starts to answer is not 'can this replace injections for weight loss?'. It is 'could a GLP-1 tablet become an early treatment option for blood sugar, alongside the tablets we already use?' There is also a plain supply argument. Injectable GLP-1 medicines have had repeated worldwide shortages. More options, in more forms, from more manufacturers, generally means fewer people left without their medicine.
What the evidence actually says
This is genuinely good evidence for what it covers, and it is important to be clear about what it does not cover. What it supports well: over 32 weeks, in people with early type 2 diabetes and no other diabetes medicines, a daily safiglipron tablet lowered HbA1c substantially more than a placebo, and got most participants to target. A 1.45 percentage point drop in HbA1c is a real effect, broadly in the range reported for injectable GLP-1 medicines in similar groups. The researchers say it provides control comparable to injectable GLP-1 receptor agonists in early type 2 diabetes. Now the limits. **It was not compared against another drug.** The comparison was a placebo tablet. That tells you the drug works. It does not tell you whether it works better than metformin, or as well as semaglutide, head to head. Those trials are a different job. **It was 284 people over 32 weeks.** That is a proper phase 3 size for this kind of study, but it is not large enough or long enough to pick up uncommon side effects or to measure what matters most in diabetes: heart attacks, strokes, kidney failure and survival over years. **It was all in China.** Trials in one country do not always translate exactly. Body size, diet, genetics and co-existing conditions all differ between populations. **The weight effect was small.** Between 0.65% and 3.56% below placebo. If you have read about injectable GLP-1 medicines producing 15% or 20% weight loss, this is not that. This trial was about blood sugar, in people with a lower starting weight than typical obesity trials. **It is not licensed in the UK.** No UK regulator has assessed it. Nothing here changes any treatment available today. So: a promising result, in an early group, over eight months, in one country, against a placebo. Worth watching. Not yet a reason to change anything.
Qurexa perspective
We deliver prescriptions, including diabetes medicines, so this is a change we would feel directly if it ever arrived in the UK. The honest observation from the delivery side is that the form of a medicine affects whether people keep taking it. Cold-chain products need planning. A missed delivery slot for something that must stay refrigerated is a bigger problem than a missed delivery of tablets. Tablets are simply easier to supply reliably, to rural addresses in particular. We are not suggesting anyone should wait for this drug or ask for it. It is not available here. If you have type 2 diabetes, the medicines you have now are the ones backed by years of UK evidence and guidance. What we would say is this: if your current diabetes medicine is difficult for you to manage, for any reason at all, that is worth raising rather than quietly living with. Pharmacists have more options to suggest than most people expect.
Practical advice
**Do not change anything because of a trial result.** This is the most important line in the article. Stopping or altering a diabetes medicine without advice can cause serious harm. **Know your HbA1c number.** If you have type 2 diabetes, ask what yours is and what your target is. It is the single most useful number to track. The trial above moved it by 1.45 points; it helps to know what your own starting point is. **Bring up any practical problems with your medicine.** Needle anxiety, difficulty using a pen device, nausea, storage, cost of travel to collect prescriptions. These are all legitimate reasons for a review, not complaints. **Ask about an annual medication review.** Your pharmacist can do this. It is free, and it is a good moment to ask whether your combination still suits you. **Be careful with GLP-1 medicines bought online.** Buying prescription injections or tablets from unregulated websites is risky and sometimes dangerous. In the UK, the MHRA has repeatedly warned about illegally supplied weight-loss injections. **If you have type 2 diabetes and are newly diagnosed, the basics still carry most of the weight.** Diet, movement, sleep and, where offered, structured education programmes. Everyone in this trial was doing diet and exercise alone before the drug was added.
What to know
A phase 3 trial published in Nature Medicine in October 2026 tested safiglipron, a once-daily GLP-1 tablet, in 284 adults with early type 2 diabetes who were on no diabetes medicines. Over 32 weeks, the 90mg dose lowered HbA1c by 1.45 percentage points more than placebo. Most people reached target blood sugar levels. Weight loss was modest, between 0.65% and 3.56% beyond placebo. The trial ran at 46 sites in China and compared the drug with a placebo, not with another medicine. It was not long enough to measure heart, kidney or survival outcomes. The drug is not licensed in the UK. The reason it is worth knowing about is the form, not the figures. A swallowed tablet removes needles, fridges and cold-chain deliveries from the picture. If GLP-1 tablets do eventually reach UK prescribing, that will matter to a lot of people. For now, nothing changes. Keep taking what you have been prescribed, and raise any practical difficulties with your pharmacist or GP rather than working around them alone. Sources: Nature Medicine, 'Oral small-molecule GLP-1 receptor agonist safiglipron in early type 2 diabetes: a randomized, double-blind, placebo-controlled trial', October 2026, https://www.nature.com/articles/s41591-026-04651-9 ; Pharmacally, 'Oral Safiglipron Demonstrates Glycemic Efficacy in Phase 3 Trial of Early Type 2 Diabetes', October 2026, https://pharmacally.com/safiglipron-hengrui-phase-3-outstand-1-type-2-diabetes/ ; NHS, 'Type 2 diabetes', accessed 4 October 2026, https://www.nhs.uk/conditions/type-2-diabetes/ This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. Never start, stop or change a prescribed medicine without speaking to a healthcare professional first.
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