2024 Top 10 Diabetes Drugs and Promising Type 1 Treatments to Watch

Brand names like the “slimming injection” and semaglutide have entered public awareness.  These diabetes drugs reflect how GLP-1–based drugs from Novo Nordisk and Eli Lilly reshaped both medical practice and consumer culture. These therapies were originally designed for glycemic control but now extend to weight management and cardiometabolic care. This report examines the top-selling diabetes therapies of 2024 and explores next-generation drug programs targeting Type 1 diabetes.

Lilly and Novo Nordisk Lead as New Players Emerge

GLP-1 receptor agonists remain the dominant therapeutic class in the diabetes market. However, an emerging trend is visible: SGLT2 inhibitors are rapidly gaining market share.

Jardiance (empagliflozin) and Forxiga (dapagliflozin) now demonstrate value beyond glucose control. Large clinical trials show benefits in heart failure and chronic kidney disease, including in non-diabetic patients. In the DAPA-CKD trial, dapagliflozin reduced the risk of kidney disease progression or renal death by about 39%. In the EMPEROR-Preserved trial, empagliflozin lowered the risk of cardiovascular outcomes by about 21% in patients with preserved ejection fraction. These benefits strengthen the role of SGLT2 inhibitors in managing diabetes and related comorbidities.

By contrast, long-acting and rapid-acting insulins such as Lantus, Humalog, and NovoRapid remain in the top rankings but face steady market pressure from newer drug classes. The diabetes treatment landscape has shifted from simple glucose lowering toward holistic benefits, including weight, heart, and kidney protection.

Top 10 Best-Selling Diabetes Drugs of 2024

Sources: Corporate financial disclosures, and interviews.

Beyond Type 2 Diabetes: New Therapies Offer Hope for Type 1 Diabetes Drugs

Although Type 2 diabetes remains more prevalent, Type 1 diabetes (T1D) affects about 2 million people in the United States alone. For a century, insulin was the only diabetes drugs option. Disease-modifying therapies (DMTs) are now reshaping the treatment landscape.

Sanofi’s Teplizumab (Tzield) became the first FDA-approved disease-modifying therapy in 2022. This anti-CD3 monoclonal antibody delays progression from Stage 2 to clinical Stage 3 T1D. In October 2025, the FDA accepted a supplemental BLA for its use in Stage 3 T1D and granted Priority Review, potentially expanding its clinical reach.

Sanofi is also developing two additional T1D immune-modulating candidates:

• Frexalimab (anti-CD40L)

• Brivekimig (dual anti-TNF/OX40L nanobody)

Both are now in Phase II trials, reflecting a strategic expansion into autoimmune therapy.

Cell-Based Approaches Gain Momentum

CellTrans’s Lantidra (donislecel) became the first FDA-approved allogeneic islet cell therapy in 2023. It is indicated for adult T1D patients with recurrent severe hypoglycemia despite optimized care. Some recipients achieve insulin independence for at least one year, though the therapy requires lifelong immunosuppression and remains complex to administer.

Vertex Pharmaceuticals is advancing Zimislecel, a stem cell-derived islet therapy. In a small cohort, about 83% of treated patients achieved insulin independence with HbA1c <7% after one year. The program has entered Phase III, with global regulatory submissions expected in 2026.

In parallel, several engineered regulatory T cell (Treg) therapies are advancing:

• GentiBio’s GNTI-122 entered Phase I in 2025.

• Immuthera (Poltreg) is preparing a Phase II/III trial for early-stage T1D.

Where the journey goes

Much like how Lilly and Novo Nordisk reshaped diabetes care over decades, new immunotherapies and cell-based platforms are now redefining possibilities for T1D. As clinical evidence expands, these treatments may enhance patient outcomes, reduce dependence on lifelong insulin, and restore metabolic stability. Their value extends beyond clinical metrics, offering patients the possibility of reclaiming everyday life—something that numbers alone cannot fully express.

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Obesity Hope or Hype: Leveraging the Efficacy of Mainstream Weight Loss Pills (First Part) Obesity Hope or Hype: Leveraging the Efficacy of Mainstream Weight Loss Pills (Second Part) The Legal Battlefield of Weight-Loss Drugs: Eli Lilly and Novo Nordisk on the Defensive Can New GLP-1 Contenders Disrupt the Weight-Loss Giants, Lilly and Novo, in the Battle for Market Dominance?

Author

Steven Chung

紅杏枝頭春意鬧固然是眾人所追求的風景，但我願意說，青蘿拂行衣更能湧生感嘆。 願在海量晦澀的生醫資訊中，為您點亮一座心燈塔。鐘煌翔