Hormonal
Tirzepatide, a dual GIP/GLP-1 receptor agonist, significantly reduces HbA1c (by 1.7–2.4%) and body weight (up to 22.5%) in patients with type 2 diabetes compared to placebo, semaglutide, and insulin therapies.
Tirzepatide is a once-weekly injection for type 2 diabetes that significantly lowers blood sugar and promotes substantial weight loss. It starts at a low dose (2.5 mg) to minimize stomach issues, then increases every 4 weeks up to 15 mg. It is more effective for weight loss and A1C reduction than insulin or semaglutide in head-to-head trials. Common side effects are gastrointestinal (nausea, diarrhea) but are usually mild. It is contraindicated for those with a history of medullary thyroid carcinoma.
Across the SURPASS research program trials, tirzepatide lowered A1C by 1.7–2.4% from baseline... Patients in the treatment groups averaged a weight loss of 5.44–11.34 kg (12–25 lb)... Across all trials, patients on tirzepatide 15 mg lost 8.8–12.9 kg (19.4–28.44 lb) or 9.17–13.7% body weight.
Why this rating
Based on multiple Phase 3 randomized controlled trials (SURPASS 1-5) with large sample sizes and statistically significant results.
Source
Tirzepatide: A Novel Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide 1 Receptor Agonist for the Treatment of Type 2 Diabetes: The First Twincretin
Alexis V. Fanshier et al. · Clinical Diabetes · 2023
DOI 10.2337/cd22-0060
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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