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(2008) Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non-inferiority study

This trial establishes the superiority of flexible-dose adjustment of oral semaglutide, which is usually followed in clinical practise in comparison with sitagliptin.[19] PIONEER 4 compares the efficacy and safety of oral semaglutide with a subcutaneously injected GLP-1 receptor agonist, liraglutide, and placebo in patients with T2DM uncontrolled on background metformin with or without an SGLT2 inhibitor

The major adverse effects associated with GLP-1 receptor agonist use are nausea and vomiting

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It lowers your metabolism and increases hunger hormones (like ghrelin), making it biologically difficult to maintain weight loss