ADA 2026: Oral GLP-1 pill delivers strong A1c and weight-loss results in type 2 diabetes

Clinical Takeaway: In adults with type 2 diabetes, once-daily oral elecoglipron significantly lowered HbA1c and promoted clinically meaningful weight loss over 26 weeks, with a safety profile consistent with the GLP-1 drug class.

An effective oral GLP-1 receptor agonist that doesn’t require injections—and may avoid the dosing restrictions associated with oral semaglutide—could expand access to GLP-1 therapy for many patients with type 2 diabetes.

A novel oral small-molecule GLP-1 receptor agonist, elecoglipron, produced significant improvements in glycemic control and body weight in the phase 2b SOLSTICE trial, according to findings presented at the ADA 2026 Scientific Sessions and published in The Lancet.

The multicenter, randomized, placebo-controlled study enrolled 406 adults with type 2 diabetes across nine countries. Participants were assigned to varying dose-escalation and maintenance regimens of once-daily oral elecoglipron or placebo and followed for 26 weeks.

Across all evaluated dose levels, elecoglipron reduced blood glucose significantly more than placebo. Up to 89.6% of treated participants achieved an HbA1c below 7.0%, compared with 24.9% of those receiving placebo. Clinically meaningful weight loss was also observed, with up to 72.3% of patients achieving at least 5% body-weight reduction versus 20.2% in the placebo group. Safety and tolerability were generally consistent with other GLP-1 receptor agonists, with GI adverse events representing the most common treatment-related effects.

“Our study’s findings underscore the expanding potential of oral GLP-1 receptor agonists for people with type 2 diabetes,” said lead investigator Vanita Aroda, MD, of Mass General Brigham. “Rigorous clinical trials like SOLSTICE can help us evaluate oral medications that may be just as effective for patients with diabetes while overcoming [current] limitations.”

The results support continued development of elecoglipron as a potential oral alternative to injectable GLP-1 therapies and add momentum to a growing class of oral incretin-based treatments.

Source: Aroda VR, et al. (2026, June 8). Lancet. Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with type 2 diabetes (SOLSTICE): a multicentre, phase 2b, randomised, placebo-controlled trial