A brand new study has confirmed that tirzepatide (Mounjaro) is essentially the most effective weight reduction drug ever for individuals with diabetes.

In 2022, tirzepatide (Mounjaro) was approved as a sort 2 diabetes medication on the strength of trials showing that it offered unprecedented glycemic improvements. Diabetes Each day said that “it could prove to be essentially the most effective type 2 diabetes drug ever developed.” Now, because of data just released, we now have a much fuller understanding of Mounjaro and weight reduction in individuals with diabetes.

The outcomes: Participants within the SURMOUNT-2 trial (PDF) lost a median of 16 percent of their body weight (about 34 kilos) over 18 months. This amount of weight reduction is best than the quantity triggered by semaglutide (Ozempic, Wegovy, Rybelsus) and nearly pretty much as good as the massive loss related to bariatric surgery.

Like Ozempic, Mounjaro mimics the consequences of the hormone GLP-1, which is released by the intestine during meals. GLP-1 does a wide range of things: It tells the liver to release less glucose, it slows digestion, and it provokes the sensation of fullness or satiety. When patients with diabetes take the drug, it reduces blood glucose levels while also helping them eat less. Mounjaro has all of those positive effects, however it moreover mimics one other hormone, glucose-dependent insulinotropic polypeptide (GIP). The mixture appears to be even simpler.

Timothy Garvey, MD, called the study “a landmark.” Dr. Garvey is the director of the diabetes research center on the University of Alabama at Birmingham; he presented the outcomes at a special symposium on the American Diabetes Association’s annual Scientific Sessions conference.

Type 2 Diabetes and Weight Loss

It’s harder to shed pounds when you’ve type 2 diabetes . Irrespective of the therapy — weight-reduction plan, medication, or bariatric surgery — individuals with diabetes invariably lose less weight than people without. “We don’t totally understand that,” says Garvey.

Consider semaglutide, which at its highest approved dose (2.4mg), confers about 10 percent lack of body mass in individuals with type 2 diabetes, based on the STEP 2 trial. However the STEP 1 trial found that individuals without diabetes will lose 15 percent of their body weight. It’s an enormous difference, based on Garvey:

“We really need medicines in diabetes to get weight reduction into the 15 percent range or higher. Why? Because we all know at that degree of weight reduction, it’s sufficient to stop a broad range of obesity-related complications.”

Garvey explained that though earlier trials suggested Mounjaro’s immense potential as an obesity medication for individuals with diabetes, the size of that weight reduction was unclear since the trials had been designed to prioritize the evaluation of glycemic control. The SURMOUNT-2 trial answers that query.

Weight Loss and Glycemic Improvement

The brand new trial evaluated two strengths of tirzepatide, 10mg and 15mg, in patients with obesity and kind 2 diabetes. Study participants, who began the trial with a median A1C of 8.0 percent and a weight of 222 kilos, used the drug for a complete of 72 weeks.

At the very best dose of tirzepatide:

• Over 80 percent of participants lost at the very least 5 percent of their body weight
• About 50 percent lost greater than 15 percent of their body weight
• About 15 percent lost greater than 25 percent of their body weight

Blood sugar improvements were similarly impressive:

• A1C declined by about 2.1 percent, from 8.0 percent to five.9 percent
• Greater than 90 percent of participants met the American consensus glycemic goal of <7.0 percent
• 55 percent achieved normal blood sugar levels (<5.7 percent)

“To think we could normalize blood sugar levels in type 2 diabetes,” Garvey stated, “it’s very impressive to me, let me put it that way.”

And despite the powerful glucose-lowering effect, there have been very low rates of mild hypoglycemia, and an entire absence of severe hypoglycemia.

There have been improvements in lots of other metabolic parameters, too: blood pressure, HDL cholesterol, triglycerides, and waist size. “These patients must buy latest clothes,” Garvey said. Fasting insulin levels dropped by 41 percent. “That’s an enormous decrease … it’s really indicative of a rise in insulin sensitivity.”

Like semaglutide (Ozempic) and other drugs within the GLP-1 receptor agonist family, tirzepatide (Mounjaro) is understood to cause gastrointestinal unwanted effects, though Garvey noted that only 21.9 percent of participants complained of nausea, which is far lower than the very best doses of semaglutide.

“Symptoms occur early, patients sort of take care of them, and we don’t fairly often must discontinue the drugs due to the unwanted effects. They get well over time.”

For many years, a debate has raged within the clinical research community: Which is more vital for type 2 diabetes management, glycemic control or weight reduction? While experts have increasingly come to a consensus on the difficulty that weight reduction is more vital, Garvey believes that Mounjaro’s results put that debate to rest:

“With a drugs like this, the purpose is moot … The medication that’s best for diabetes control can also be best for weight reduction.

“Patients with type 2 diabetes and obesity have two diseases and each warrant optimal treatment … it is a therapeutic gap that tirzepatide could fill.”

High Prices Remain Problematic

When asked in regards to the high price of Mounjaro, and whether it would exacerbate diabetes and obesity disparities, Garvey didn’t mince words.

“This kills me. These medicines are very expensive, but these costs limit access, and insurers don’t wish to open the dam up and treat everyone.

“To me, it comes right down to risk stratification. Should you can discover the patients that need it essentially the most … but that might imply a rational way of coping with disease within the US, and it ain’t gonna occur any time soon.

“I just wish we had higher access, and I wish that patients within the US were paying the identical as patients in other countries.”

Garvey movingly described how some trial participants were in tears on the conclusion of the trial, knowing that they couldn’t afford to proceed taking the drug that had helped them a lot.

Garvey, like other experts, expects tirzepatide to win approval as a weight-loss medication for people without diabetes later this 12 months. It’s difficult to take a position, nevertheless, on the ways in which the change could affect access and affordability for individuals with diabetes that use or wish to make use of Mounjaro. There have been intermittent Mounjaro shortages because it was approved one 12 months ago, possibly as a result of the massive variety of patients which are using the medication off-label for weight reduction.