Issue: October 2024
Fact checked byRichard Smith

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August 20, 2024
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Tirzepatide cuts risk for progression to type 2 diabetes for adults with prediabetes

Issue: October 2024
Fact checked byRichard Smith
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Key takeaways:

  • In SURMOUNT-1, adults with prediabetes receiving tirzepatide were 94% less likely to develop type 2 diabetes than placebo at 176 weeks.
  • Those receiving 15 mg tirzepatide lost 22.9% of their body weight.
Perspective from Robert H. Eckel, MD

Adults with prediabetes and overweight or obesity have a 94% lower risk for developing type 2 diabetes with the once-weekly GIP/GLP-1 dual agonist tirzepatide vs. placebo, according to top-line results from the SURMOUNT-1 3-year study.

SURMOUNT-1 was a randomized, double-blind, placebo-controlled trial in which adults with overweight plus one weight-related comorbidity or obesity and without type 2 diabetes were randomly assigned to receive 5 mg, 10 mg or 15 mg tirzepatide (Mounjaro/Zepbound, Eli Lilly) or placebo for 72 weeks. As Healio previously reported, adults with overweight or obesity without diabetes lost 20.9% of their body weight at 72 weeks with 15 mg tirzepatide.

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Tirzepatide lowered the risk for progression to type 2 diabetes among adults with prediabetes and overweight or obesity in the SURMOUNT-1 3-year trial. 

The SURMOUNT-1 trial included 1,032 participants with prediabetes at the start of the study. Those participants continued to receive treatment for 104 weeks beyond the trial’s initial 72-week completion date. Researchers compared progression to type 2 diabetes and change in body weight between adults receiving tirzepatide and those receiving placebo as part of a secondary analysis.

In the efficacy estimand, tirzepatide lowered the risk for progression from prediabetes to type 2 diabetes by 94% compared with placebo (P < .0001). Adults receiving 15 mg tirzepatide lost 22.9% of their body weight by the end of the 176-week treatment period compared with a 2.1% weight reduction for the placebo group (P < .001). Mean weight loss at 176 weeks was 15.4% for adults in the 5 mg tirzepatide group and 19.9% for those receiving 10 mg tirzepatide.

A 17-week off-treatment follow-up period occurred after the 176-week treatment period. While off treatment, some participants who discontinued tirzepatide started to regain weight and had progression to type 2 diabetes. The risk for progression from prediabetes to type 2 diabetes at the end of the off-treatment period was 88% lower in the tirzepatide group compared with placebo (P < .0001).

The safety and tolerability profile of tirzepatide was similar to the primary results of SURMOUNT-1 and other tirzepatide trials. The most common adverse events were gastrointestinal-related and included diarrhea, nausea, constipation and vomiting. Most were mild to moderate in severity.

“Obesity is a chronic disease that puts nearly 900 million adults worldwide at an increased risk of other complications such as type 2 diabetes,” Jeff Emmick, MD, PhD, senior vice president of product development at Lilly, said in the release. “Tirzepatide reduced the risk of developing type 2 diabetes by 94% and resulted in sustained weight loss over the 3-year treatment period. These data reinforce the potential clinical benefits of long-term therapy for people living with obesity and prediabetes.”