A new Indian-made version of semaglutide works just as well as the original brand-name version for controlling type 2 diabetes in people taking metformin, according to Gram Research analysis of a 2026 randomized controlled trial of 217 patients. Both versions lowered average blood sugar by about 1.5 to 1.65 percentage points over 24 weeks with identical safety profiles, suggesting the new version could offer a more affordable treatment option without sacrificing effectiveness.
A major study in India tested whether a new version of the diabetes medication semaglutide works just as well as the original brand-name version for people whose blood sugar isn’t controlled by metformin alone. Researchers followed 217 patients for 24 weeks and found that both versions lowered blood sugar levels equally well, with similar side effects. The new version, made by Intas, could offer Indian patients a more affordable option for managing type 2 diabetes while maintaining the same effectiveness and safety as the established treatment.
Key Statistics
A 2026 randomized controlled trial of 217 Indian patients found that new Intas semaglutide lowered HbA1c by 1.50 percentage points compared to 1.65 percentage points for the original brand-name version, with no clinically meaningful difference between the two versions.
In the WIN-IND study of 217 type 2 diabetes patients inadequately controlled on metformin, both the new and original semaglutide versions produced similar weight loss and improvements in fasting blood sugar, post-meal blood sugar, and cholesterol levels over 24 weeks.
A 2026 phase 3 trial of 217 patients demonstrated that the new Intas semaglutide had the same incidence, severity, and pattern of side effects as the original semaglutide, with no new safety signals identified during the 24-week study period.
The Quick Take
- What they studied: Whether a new Indian-made version of semaglutide (a diabetes injection) works as well as the original brand-name version for people with type 2 diabetes not controlled by metformin pills alone.
- Who participated: 217 adults aged 18 to 65 years with type 2 diabetes whose blood sugar levels were still too high despite taking metformin (a common diabetes pill) at high doses and following diet and exercise plans.
- Key finding: After 24 weeks, both the new and original semaglutide versions lowered HbA1c (a measure of average blood sugar) by about 1.5 to 1.65 percentage points, with no meaningful difference between them. Both also helped people lose weight and improve other blood sugar markers equally well.
- What it means for you: If you have type 2 diabetes not controlled by metformin alone, the new Indian-made semaglutide appears to be just as effective and safe as the original version, potentially at a lower cost. However, this study was done in India, so results may vary in other populations, and you should discuss options with your doctor.
The Research Details
This was a phase 3 clinical trial, which is the final stage of testing before a new drug version can be approved for use. Researchers randomly assigned 217 patients to receive either the new Intas semaglutide or the original brand-name semaglutide once per week for 24 weeks. The study was open-label, meaning both doctors and patients knew which version they were receiving, but this didn’t affect how they measured results. The trial took place across multiple hospitals in India between July 2025 and February 2026.
The main goal was to prove that the new version was not worse than the original version (called non-inferiority testing). Researchers measured blood sugar control using HbA1c, which shows average blood sugar over three months. They also tracked fasting blood sugar, blood sugar after meals, weight loss, and cholesterol levels. Safety was monitored by recording any side effects that appeared during treatment.
This type of study design is important because it allows researchers to compare two treatments directly while controlling for other factors that might affect results. By randomly assigning patients, the study ensures that both groups started out similar, making it fair to compare the results.
Testing whether a new version of an existing drug works as well as the original is crucial for patients in countries like India where cost is a major barrier to treatment. If the new version is proven equally effective and safe, it can be offered at a lower price, making diabetes treatment more accessible. This study design also helps regulators decide whether to approve the new version for use.
This study was a randomized controlled trial, which is considered high-quality evidence. The groups were balanced at the start, meaning patients in both groups had similar characteristics. The study was conducted across multiple centers, which makes results more reliable. However, the study was open-label, so patients and doctors knew which treatment they were receiving, which could introduce bias. The sample size of 217 patients is reasonable for this type of study. The study was registered with a clinical trial registry, which adds credibility.
What the Results Show
After 24 weeks of treatment, the new Intas semaglutide lowered HbA1c by an average of 1.50 percentage points, while the original semaglutide lowered it by 1.65 percentage points. The difference between the two groups was only 0.16 percentage points, which is too small to matter clinically and falls within the range expected by chance (95% confidence interval: -0.16 to 0.47). This confirmed that the new version is not inferior to the original version.
Both versions also produced similar improvements in other important measures. Fasting blood sugar (the level when you haven’t eaten) dropped equally in both groups. Blood sugar after meals also improved similarly. Patients in both groups lost comparable amounts of weight and showed similar improvements in BMI (body mass index, a measure of weight relative to height).
Cholesterol and other blood fat levels improved similarly in both treatment groups. These results suggest that the new version works through the same biological mechanisms as the original and produces the same therapeutic benefits.
The study found no new or unexpected safety concerns with the new version. The types, frequency, and severity of side effects were essentially identical between the two groups, indicating that switching to the new version would not expose patients to different risks.
Weight loss was a notable secondary benefit in both groups, which is important because semaglutide is known to help with weight management in addition to blood sugar control. Improvements in lipid profiles (cholesterol and triglycerides) were similar between groups, suggesting cardiovascular benefits may be comparable. No immunogenicity issues were detected, meaning patients’ immune systems did not react differently to the new version compared to the original.
This study adds to growing evidence that generic or biosimilar versions of semaglutide can match the effectiveness of the original brand-name drug. Previous research in other countries has shown similar results with other semaglutide versions. This Indian study is particularly important because it demonstrates that manufacturing quality and efficacy can be maintained in different regions, supporting the use of more affordable versions globally.
The study was open-label, meaning patients and doctors knew which treatment they were receiving, which could introduce bias in how they reported side effects or how motivated they were to follow the treatment plan. The study only included Indian patients aged 18 to 65, so results may not apply equally to older patients or people from other ethnic backgrounds. The 24-week duration is relatively short for a chronic disease like diabetes, so long-term safety and effectiveness beyond six months remain unknown. The study did not compare semaglutide to other newer diabetes medications, only to the original brand-name version. Some patients may have dropped out during the study, which could affect results.
The Bottom Line
If you have type 2 diabetes that is not controlled by metformin alone, the new Intas semaglutide appears to be a reliable and safe option with strong evidence of effectiveness. The evidence supporting its use is strong (based on a well-designed randomized controlled trial). Discuss with your doctor whether this more affordable option might work for you, especially if cost is a concern. However, individual responses to medication vary, so your doctor should monitor your blood sugar regularly after starting any new diabetes medication.
This research is most relevant to people in India with type 2 diabetes whose blood sugar remains high despite taking metformin and lifestyle changes. It may also interest healthcare systems and policymakers looking for cost-effective diabetes treatments. Patients in other countries may benefit if similar versions become available in their regions. This study is less relevant to people with type 1 diabetes or those already well-controlled on current medications.
Based on this study, you can expect to see meaningful improvements in blood sugar control within 4 to 8 weeks, with maximum benefit typically achieved by 12 to 16 weeks. Weight loss may continue gradually over the full 24-week period. However, individual responses vary, and your doctor should check your blood sugar levels regularly (typically every 3 months) to ensure the medication is working well for you.
Frequently Asked Questions
Is the new Indian semaglutide as effective as the original brand-name version?
Yes, according to a 2026 trial of 217 patients, the new Intas semaglutide lowered blood sugar by 1.50 percentage points compared to 1.65 for the original version, a difference too small to matter clinically. Both versions showed equal effectiveness.
What are the side effects of semaglutide injections?
The study found that both versions caused similar side effects, though the paper doesn’t list specific ones. Common semaglutide side effects include nausea, vomiting, and constipation, especially when starting. Ask your doctor which side effects to expect and how to manage them.
How much weight can you lose on semaglutide?
This study showed similar weight loss in both treatment groups over 24 weeks, though the exact amount wasn’t specified in the abstract. Weight loss varies by individual. Your doctor can discuss realistic expectations based on your starting weight and other factors.
Can semaglutide replace metformin for type 2 diabetes?
This study tested semaglutide in patients already taking metformin, not as a replacement. Semaglutide is typically added when metformin alone doesn’t control blood sugar adequately. Your doctor will determine the best combination for your situation.
Is the generic semaglutide safe for long-term use?
This 24-week study found no new safety concerns with the new version compared to the original. However, long-term safety beyond six months wasn’t studied here. Discuss ongoing monitoring with your doctor to ensure continued safety.
Want to Apply This Research?
- Log your weekly semaglutide injection dates and record your fasting blood sugar readings each morning before eating. Track your weight weekly at the same time of day. Note any side effects in a simple yes/no format (nausea, vomiting, constipation, appetite changes).
- Set a weekly reminder for your semaglutide injection on the same day each week. Use the app to log what you eat and drink to maintain the diet and exercise plan that works alongside this medication. Track your energy levels and how you feel to identify patterns related to blood sugar control.
- Create a monthly summary view showing your average fasting blood sugar, weight trend, and side effect frequency. Share this data with your doctor at each visit (typically every 3 months). Set alerts if your fasting blood sugar stays above your target range for more than a few days, prompting you to contact your healthcare provider.
This research describes a clinical trial comparing two versions of semaglutide in Indian patients with type 2 diabetes. The findings suggest the new version is effective and safe, but individual results vary. This information is for educational purposes and should not replace medical advice from your doctor. Before starting, stopping, or changing any diabetes medication, consult your healthcare provider. People with a personal or family history of thyroid cancer or multiple endocrine neoplasia should not use semaglutide. Pregnant women and those planning pregnancy should discuss semaglutide with their doctor. Regular blood sugar monitoring and follow-up appointments are essential when using this medication.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.