A post hoc analysis of SUSTAIN-6 linked worsening of DR to the rate of glycemic improvement, with the semaglutide group experiencing HbA1c reductions of 1.9% to 2.5% by week 16, compared with slower reductions in the placebo group.20 Additionally, a trial in patients with T2D and a body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 reported worsening of DR in 4.0% of patients who were treated with semaglutide vs 2.7% of patients who received placebo.21 This difference was attributed to baseline DR history and insulin use. This evidence concerns the gene INS and type 2 diabetes mellitus.