Foundayo posts superior A1c control and weight loss in three diabetes trials

Eli Lilly reported that Foundayo (orforglipron), a once-daily pill already approved for weight loss, showed better blood sugar control and weight loss than comparison drugs across three late-stage studies in people with type 2 diabetes ^[1][2]. The results, from the ACHIEVE-2, ACHIEVE-3 and ACHIEVE-5 trials, were presented at the American Diabetes Association's Scientific Sessions held June 5 to 8, 2026, in New Orleans ^[2].

Foundayo is the brand name for orforglipron, a small-molecule GLP-1 drug that does not require injections and can be taken without food or water restrictions ^[1]. The FDA first approved it on April 1, 2026, for weight loss in adults with obesity or with overweight plus a weight-related health problem ^[1]. It is not yet approved for diabetes.

In ACHIEVE-2, a 40-week trial of 962 adults with type 2 diabetes on metformin, orforglipron lowered A1C more than the diabetes pill dapagliflozin at all three doses tested, with reductions of 1.2 to 1.6 percentage points versus 0.8 points for dapagliflozin ^[2]. Higher doses of orforglipron also produced more weight loss and better cholesterol and blood pressure numbers than dapagliflozin, though more people stopped taking orforglipron because of side effects ^[2].

In ACHIEVE-3, a 52-week trial of 1,698 adults, orforglipron at 12 mg or 36 mg lowered A1C more than oral semaglutide (Rybelsus) at 7 mg or 14 mg, with reductions up to 1.9 percentage points versus up to 1.5 points for semaglutide ^[2]. Separately, Lilly reported that orforglipron 36 mg led to a 19.7-pound weight loss compared with 11.0 pounds for oral semaglutide 14 mg, a 73.6% greater relative weight loss ^[1].

In ACHIEVE-5, a 40-week trial of 546 people already on insulin glargine, orforglipron lowered A1C by 1.6 to 1.9 percentage points compared with 0.8 points for placebo, without a higher rate of serious low blood sugar ^[2]. Weight fell 2.6% to 5.4% with orforglipron versus 0.2% with placebo ^[2]. Across all three trials, side effects were mostly gastrointestinal — nausea, diarrhea, and stomach pain — consistent with other GLP-1 drugs, though discontinuations because of side effects were more common with orforglipron than with the comparison drugs in two of the studies ^[2].

Why it matters for patients

For people with type 2 diabetes who want to avoid injections, an oral pill that appears to outperform an SGLT2 inhibitor and oral semaglutide on blood sugar control could become an important option ^[1][2]. But Foundayo is not currently approved for diabetes; it is approved only for weight loss ^[1]. Whether and when the FDA might approve it for diabetes is not stated in these sources.

Patients considering any GLP-1 medication should be aware Foundayo carries a boxed warning about thyroid C-cell tumor risk, along with warnings for pancreatitis, gastrointestinal problems, kidney injury from dehydration, and gallbladder disease ^[1]. Discontinuation rates due to side effects were higher with orforglipron than with dapagliflozin and than with insulin glargine plus placebo in the trials described ^[2], meaning tolerability varies by comparison drug and dose.

What happens next

The three studies were published alongside the ADA presentations: ACHIEVE-2 in The Lancet, ACHIEVE-3 previously in The Lancet, and ACHIEVE-5 in JAMA ^[2]. These sources do not say when or whether Lilly will file for a diabetes-specific FDA approval, so that timeline is not yet known.