a research study to look into how semaglutide, together with a lower dose of insulin glargine, compares to a higher dose of insulin glargine alone in people with type 2 diabetes (sustain optimize)

Conditions: Diabetes Mellitus, Type 2; Obesity

Summary: this study compares semaglutide, together with a lower dose of insulin glargine, to a higher dose of insulin glargine in participants with type 2 diabetes. the study looks at how well the study medicines control blood glucose levels. participants will either get semaglutide together with a lower dose of insulin glargine or a higher dose of insulin glargine. the study will last for about 47 weeks (approximately 11 months). participants will have 9 clinic visits, 15 phone/video calls and 1 home visit. participants will be asked to wear a sensor that measures their blood sugar all the time in 2 periods of 10 days during the study.


Eligibility criteria:
inclusion criteria: * diagnosed with type 2 diabetes mellitus (t2d) mellitus greater than or equal to (\>=) 180 days before screening. * glycated haemoglobin (hba1c) of 7-10 percentage \[(53-86 millimoles per mole (mmol/mol)\] (both inclusive) as assessed by central laboratory on the day of screening. * body mass index (bmi) greater than or equal to (\>=) 25 kilograms per meter square (kg/m\^2) on the day of screening. * stable daily dose(s) greater than or equal to (\>=) 90 days before screening of any of the following anti-diabetic drugs or combination regimens: * any metformin formulations greater than or equal to (\>=) 1500 milligrams (mg) or maximum tolerated or effective dose. * any metformin combination formulation greater than or equal to (\>=) 1500 mg or maximum tolerated or effective dose. the treatment can be with or without sodium glucose cotransporter 2 (sglt-2) inhibitors. • treated with a once daily basal insulin (e.g. insulin glargine unit 100 or u300, neutral protamine hagedorn (nph) insulin, insulin detemir, insulin degludec) less than or equal to (\ =) 90 days before screening. short-term bolus insulin treatment for a maximum of 14 days before screening is allowed. exclusion criteria: * uncontrolled and potentially unstable diabetic retinopathy or maculopathy. verified by a fundus examination performed within the past 90 days before screening or in the period between screening and randomisation. pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination. * potentially missed diagnosis of type 1 diabetes (t1d) or latent autoimmune diabetes in adults (lada) verified by c-peptide less than 0.26 nanomoles per litre (nmol/l) (or 260 picomoles per liter \[pmol/l\] \[0.78 nanograms per millilitre {ng/ml}\]) or antibodies to glutamic acid decarboxylase (anti-gad) greater than 5 units/millilitre, as measured by the central laboratory at screening. * presence or history of pancreatitis (acute or chronic). * renal impairment measured as estimated glomerular filtration rate (egfr) value of less than 30 millilitre per minute per 1.73 meter square at screening as defined by kidney disease: improving global outcomes (kdigo) 2012 classification. * any episodes of diabetic ketoacidosis within 90 days before screening. * known hypoglycaemic unawareness as indicated by the investigator according to clarke's questionnaire question 8.