Effects of Tirzepatide Versus Basal Insulins in People With Type 2 Diabetes and Different Baseline Glycemic Patterns: Post Hoc Analyses of the SURPASS-3 and SURPASS-4 Trials

Diabetes Care. 2024 Jun 1;47(6):1020-1027. doi: 10.2337/dc23-2366.

Abstract

Objective: This post hoc analysis assessed change from baseline to week 52 in glycemic parameters for tirzepatide (5, 10, 15 mg) versus insulin degludec (SURPASS-3 trial) and glargine (SURPASS-4 trial) in people with type 2 diabetes and different baseline glycemic patterns, based on fasting serum glucose (FSG) and postprandial glucose (PPG) values.

Research design and methods: Participant subgroups with low FSG/low PPG, low FSG/high PPG, high FSG/low PPG, and high FSG/high PPG were defined according to the median values of these measures.

Results: All tirzepatide doses and basal insulins were associated with decreased HbA1c, FSG, and PPG values from baseline to week 52 in all subgroups (P < 0.05). Within each subgroup, HbA1c and PPG decreases were greater with tirzepatide than insulin (P < 0.05). FSG decreases were generally similar. There were no differential treatment effects by FSG/PPG subgroup.

Conclusions: In this post hoc analysis, tirzepatide was associated with superior glycemic control compared with insulin, irrespective of baseline glycemic pattern.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Blood Glucose* / drug effects
  • Blood Glucose* / metabolism
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / drug therapy
  • Female
  • Gastric Inhibitory Polypeptide
  • Glucagon-Like Peptide-2 Receptor
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / therapeutic use
  • Insulin Glargine* / administration & dosage
  • Insulin Glargine* / therapeutic use
  • Insulin, Long-Acting* / therapeutic use
  • Male
  • Middle Aged

Substances

  • tirzepatide
  • insulin degludec

Grants and funding