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If weight loss is not a particular concern and only a small decrease in A1C is required, a DPP-4 inhibitor may be better choice

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reported that semaglutide accessed the brainstem, hypothalamus, and the dorsal half of the septal area, largely via small circumventricular organs, but it was not shown to cross the BBB [27]

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Differences in receptor binding and pharmacodynamics could explain this observation, but further investigation is needed to determine whether the differences stem from drug properties, population characteristics or both. The authors also disclosed their inability to establish causality for the association between semaglutide and ocular AEs, noting that the biological mechanisms remain unclear