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They switch because external factors force their hand or because specific side effects become intolerable

These clinically challenging situations are based on the crossroads described in the American Diabetes Association algorithm for pharmacological treatment of T2DM

Although the half-life of oral semaglutide is 1 week, once-daily administration of oral semaglutide is required to achieve therapeutic steady-state activity and to mitigate the low bioavailability and high variability in semaglutide exposure after a single oral dose (15,37)

Side effects include but are not limited to thyroid tumors, multiple endocrine neoplasia type 2, hoarseness, trouble swallowing, shortness of breath, pancreatitis, acid reflux, nausea, and allergic reactions to the medication