4 Oct 2023 • Efficacy and safety of adding tirzepatide vs prandial insulin to treatment in patients with inadequate glycemic control with basal insulin have not yet been described. Hence, in a study published in JAMA, researchers aimed to assess the efficacy and safety of tirzepatide vs insulin lispro as an adjunctive therapy to insulin glargine.

• In a phase 3b clinical trial, researchers investigated the effectiveness and safety of adding once-weekly tirzepatide, a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, compared to thrice-daily prandial insulin lispro as adjunctive therapy to insulin glargine in adults with type 2 diabetes who were inadequately controlled on basal insulin.
• The study involved 1,428 participants across 15 countries. The results showed that after 52 weeks, tirzepatide led to a significant improvement in glycemic control, with a mean reduction in hemoglobin A1c (HbA1c) of -2.1% compared to -1.1% with insulin lispro.
• Additionally, tirzepatide resulted in substantial weight loss (an estimated mean change of -9.0 kg) compared to weight gain with insulin lispro (an estimated mean change of 3.2 kg).
• Furthermore, a higher percentage of participants on tirzepatide achieved the HbA1c target of less than 7.0% (68% vs. 36% with insulin lispro), and there were fewer hypoglycemic events with tirzepatide.

In people with inadequately controlled type 2 diabetes treated with basal insulin, weekly tirzepatide compared with prandial insulin as an additional treatment with insulin glargine demonstrated reductions in HbA1c and body weight with less hypoglycemia.

Source: JAMA | Read full story