How will we treat diabetes and obesity in the coming years? Here is the future of treatments

The number of studies on new treatments for diabetes and obesity presented at the American Diabetes Association (ADA 2026 Scientific Sessions) is truly remarkable. The menu of what's next is truly diverse and there is something for everyone: from new oral and injectable drugs (dual and triple agonists) to once-monthly therapies. And the stakes are rising: no longer just anti-diabetes and anti-obesity drugs, but therapies to improve overall health. New treatment strategies are also being defined to minimise side effects (nausea, vomiting, constipation, etc.) under the motto ‘stay low, go slow’ (start with a low dose and increase it very gradually). “We need a range of different treatment options,” comments Professor Naveed Sattar of the University of Glasgow. “But the most important thing is that the medicines are scalable and accessible to most people, not just in high-income countries. The (obesogenic) environment won’t return to how it was in the 1970s within a week. It will take three, four, five generations. But we need solutions now.”

Among the new key players in the fight against obesity and diabetes is amylin, a hormone produced by the pancreas, which forms the basis of a new generation of effective drugs. The results of a series of studies involving amylin derivatives, either as monotherapy or in combination therapy, were presented at the ADA, including those from the REDEFINE programme. Patients treated with a combination of cagrilintide (a long-acting amylin analogue) and semaglutide achieved double-digit reductions in body weight. Promising results for this combination were also seen in type 2 diabetes, from the phase 3 studies of the REIMAGINE programme (published in The Lancet), showing significant reductions in blood glucose and body weight, and with the potential to bring diabetes into remission if used in the early stages of the disease. Also on the horizon for this category is eloralintide, another long-acting selective amylin receptor agonist.

Amylin promotes weight loss by reducing calorie intake (through its action on the brain) and counteracting the decrease in energy expenditure that typically accompanies low-calorie diets and slows down weight loss. It also appears to offer benefits for bone health, muscle mass and leptin sensitivity, making it particularly attractive for long-term treatment.

It is called berobenatide and is a GLP-1 agonist taken once a month, rather than once a week like current injectable treatments. It is a drug that could therefore radically change adherence to obesity treatment. The results of the three Phase 2b trials from the VESPER programme were presented at the ADA. Berobenatide could therefore become the first monthly GLP-1 receptor agonist. It is very potent and well-tolerated, and its long duration of action could improve treatment adherence.

Whilst anticipation is growing for the arrival in pharmacies of orforglipron – an anti-obesity and anti-diabetes tablet that is already a strong contender for type 2 diabetes, mild overweight and obesity, and as a maintenance therapy following weight loss – new molecules are already emerging from research laboratories, set to join those already available (oral semaglutide) or on the horizon (orforglipron). This is the case with elecoglipron, a small molecule taken orally once a day. At ADA 2026, the results of two phase 2 studies were presented, published simultaneously in The Lancet. In SOLSTICE, involving people with type 2 diabetes, the drug produced an average reduction in glycated haemoglobin of up to 1.9 percentage points. In the VISTA study, involving adults who were obese or overweight, those treated with elecoglipron lost an average of 10.5% of their body weight over 26 weeks. The drug also improved blood pressure readings and reduced levels of C-reactive protein, a marker of inflammation linked to cardiovascular risk. Phase 3 trials are currently under development to test elecoglipron in larger and more diverse populations. Results are not expected before the end of next year.