scholarly journals Tirzepatide: A Useful Addition for Treatment of Type 2 Diabetes and Obesity

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Serum Triglyceride ◽  
Drug Discontinuation ◽  
High Dose ◽  
Phase 3 ◽  
Pubmed Search ◽  
Diabetes And Obesity ◽  
Hba1c Levels

Background: Tirzepatide is a dual receptor agonist of the 2 incretin hormones: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) which is currently under development. Objective: To clarify the potential role of tirzepatide for treatment of type 2 diabetes and obesity. Methods: Pubmed search until August 2nd, 2021. Search terms were GLP-1, GIP, incretins, tirzepatide, efficacy, safety. Clinical trials and pertinent reviews were included. Results: In one phase 3 clinical trial, mean reduction of glycated hemoglobin (HbA1c) with tirzepatide (5-15 mg/week) was -1.87% to -2.07% versus + 0.04% with placebo after 40 weeks. In another phase 3 randomized trial, tirzepatide decreased HbA1c levels by -2.01% to -2.3% versus -1.86% with semaglutide (1.0 mg/week) (P<0.0001). In the previous 2 studies, tirzepatide use was associated with dose-related mean weight loss at 40 weeks of -7.0 kg to -9.5 kg vs -0.7 kg with placebo (P<0.0001) and -7.6 kg to -11.2 kg vs -5.7 kg with semaglutide ((P<0.001). Tirzepatide had generally favorable effects on lipid profile, particularly on lowering serum triglyceride levels: -19% to -24.8% mean reduction compared with -11.5% with semaglutide. Gastrointestinal (GI) adverse effects were the commonest reported symptoms associated with tirzepatide use and occurred more frequently than with placebo and semaglutide. Hypoglycemia was reported more coomonly with high-dose terzipatide (1.7%) compared with semaglutide (0.4%). Drug discontinuation rates due to adverse effects were 6-8.5 % with tirzepatide vs 4.1% with semaglutide. Conclusions: Available data from 2 short-term randomized trials suggest that tirzepatide may be more effective than placebo and the GLP-1 agonist semaglutide in reducing HbA1c levels and body weight. Pattern of safety profile of tirzepatide is similar to that of GLP-1 agonists, but frequency of GI adverse effects and hypoglycemia is more common with tirzepatide.

scholarly journals Tirzepatide: A Useful Addition for Treatment of Type 2 Diabetes and Obesity

2021 ◽  
Vol 5 (5) ◽  
pp. 01-04
Author(s):  
Nasser Mikhail
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Serum Triglyceride ◽  
Drug Discontinuation ◽  
High Dose ◽  
Phase 3 ◽  
Pubmed Search ◽  
Diabetes And Obesity ◽  
Hba1c Levels

Background: Tirzepatide is a dual receptor agonist of the 2 incretin hormones: glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) which is currently under development. Objective: To clarify the potential role of tirzepatide for treatment of type 2 diabetes and obesity. Methods: Pubmed search until August 5th, 2021. Search terms were GLP-1, GIP, incretins, tirzepatide, efficacy, safety. Clinical trials and pertinent reviews were included. Results: In one phase 3 clinical trial, mean reduction of glycated hemoglobin (HbA1c) with tirzepatide (5-15 mg/week) was -1.87 to -2.07% versus + 0.04% with placebo after 40 weeks. In another phase 3 randomized trial, tirzepatide decreased HbA1c levels by -2.01% to -2.3% versus -1.86% with semaglutide (1.0 mg/week) (P<0.0001). In the previous 2 studies, tirzepatide use was associated with dose-related mean weight loss at 40 weeks of -7.0 kg o -9.5 kg vs -0.7 kg with placebo (P<0.0001) and -7.6 kg to -11.2 kg vs -5.7 kg with semaglutide ((P<0.001). Tirzepatide had generally favorable effects on lipid profile, particularly on lowering serum triglyceride levels: -19% to -24.8% mean reduction compared with -11.5% with semaglutide. Gastrointestinal (GI) adverse effects were the commonest reported symptoms associated with tirzepatide use and occurred more frequently than with placebo and semaglutide. Hypoglycemia was reported more coomonly with high-dose terzipatide (1.7%) compared with semaglutide (0.4%). Drug discontinuation rates due to adverse effects were 6-8.5 % with tirzepatide vs 4.1% with semaglutide. Conclusions: Available data from 2 short-term randomized trials suggest that tirzepatide may be more effective than placebo and the GLP-1 agonist semaglutide in reducing HbA1c levels and body weight. Pattern of safety profile of tirzepatide is similar to that of GLP-1 agonists, but frequency of GI adverse effects and hypoglycemia is more common with tirzepatide.

Tu1502 Longitudinal Monitoring of Lipase and Amylase in Adults With Type 2 Diabetes and Obesity: Evidence From Two Phase 3 Randomized Clinical Trials With the Once-Daily GLP-1 Analog Liraglutide

2012 ◽  
Vol 142 (5) ◽  
pp. S-850-S-851 ◽  
Author(s):  
William Steinberg ◽  
J. Hans DeVries ◽  
Thomas A. Wadden ◽  
Christine Bjørn Jensen ◽  
Claus Bo Svendsen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Phase 3 ◽  
Two Phase ◽  
Once Daily ◽  
Diabetes And Obesity

scholarly journals Real-World Clinical Experience on the Usage of High-Dose Metformin (1500-2500 mg/day) in Type 2 Diabetes Management

2021 ◽  
Vol 14 ◽  
pp. 117955142110305
Author(s):  
Ashok Kumar Das ◽  
Sanjiv Shah ◽  
Santosh Kumar Singh ◽  
Archana Juneja ◽  
Niroj Kumar Mishra ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Real World ◽  
Diabetes Management ◽  
Clinical Effectiveness ◽  
High Dose ◽  
Global Evaluation ◽  
The Mean ◽  
High Doses ◽  
Hba1c Levels

Background: To evaluate the clinical characteristics, treatment patterns, and clinical effectiveness and safety of high doses of metformin (1500-2500 mg/day) in Indian adults with type 2 diabetes mellitus (T2DM). Materials and methods: A retrospective, multicentric (n = 241), real-world study included patients with T2DM (aged >18 years) receiving high doses of metformin. Details were retrieved from patient’s medical records. Results: Out of 5695 patients, 62.7% were men with median age was 50.0 years. Hypertension (67.5%) and dyslipidemia (48.7%) were the prevalent comorbidities. Doses of 2000 mg (57.4%) and 1500 mg (29.1%) were the most commonly used doses of metformin and median duration of high-dose metformin therapy was 24.0 months. Metformin twice daily was the most frequently used dosage pattern (94.2%). Up-titration of doses was done in 96.8% of patients. The mean HbA1c levels were significantly decreased post-treatment (mean change: 1.08%; P < .001). The target glycemic control was achieved in 91.2% patients. A total of 83.0% had decreased weight. Adverse events were reported in 156 patients. Physician global evaluation of efficacy and tolerability showed majority of patients on a good to excellent scale (98.2% and 97.7%). Conclusion: Clinical effectiveness and safety of a high-dose metformin was demonstrated through significant improvement in HbA1c levels and weight reduction.

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

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