In The Lancet, Richard Pratley and colleagues describe the results of the PIONEER 4 trial,1 a controlled, double-dummy, double-blind, 52-week phase 3a trial comparing the safety and effects of two glucagon-like peptide-1 (GLP-1) receptor agonists for diabetes therapy. They randomly assigned 711 eligible patients with type 2 diabetes uncontrolled with metformin (with or without additional sodium-glucose co-transporter-2 [SGLT2] inhibitor treatment) to the newly developed oral agonist semaglutide2 (dose escalated to 14 mg once daily; n=285), the once-daily injectable agonist liraglutide (dose escalated to 1·8 mg; n=284), and placebo (n=142).