The SURMOUNT 2 trial revealed significant weight loss for tirzepatide, a glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide (GLP-1/GIP) dual receptor agonist, and makes the case for shifting from a glucose-centric approach to type 2 diabetes to a weight-centric one.

The study’s principal investigator, W. Timothy Garvey, MD, will lead the Scientific Sessions presentation of SURMOUNT 2 Trial Results and Potential Role of Tirzepatide in Treating Obesity in Type 2 Diabetes on Friday, June 23, at 3:45 p.m. PT in Ballrooom 20A-C. This session also will be available via livestream for registered meeting participants.

“Tirzepatide reduces weight in patients who have both obesity and type 2 diabetes to an extent we haven’t seen before, greater than any other clinical trials and other weight loss medications,” said Dr. Garvey, Professor of Nutrition Sciences at the University of Alabama at Birmingham and Director of the UAB Diabetes Research Center.

In topline results released in March, participants with obesity and type 2 diabetes on a 15 mg dose of tirzepatide lost 15% more weight than those given placebo. The symposium also will review additional results from the trial, including blood pressure, lipids, A1C, and other key endpoints, as well as the tirzepatide safety profile.

Achieving a durable 15% weight loss or greater for individuals with both obesity and type 2 diabetes has been an elusive goal, Dr. Garvey said. Such a reduction in initial body weight can treat or prevent a broad array of complications related to both conditions. Dr. Garvey has proposed the term “second-generation obesity medications” for agents that produce this level of weight loss because of the health benefits associated with treating obesity complications.

“We tend to pay extra attention to glycemic control in patients who have diabetes,” he said. “But for patients who also have obesity, the extra weight not only exacerbates their diabetes, but also leads to every other complication of obesity, metabolic or biomechanical. Sleep apnea is very common in obesity, as are osteoarthritis, stress urinary incontinence, GERD, as well as other quality-of-life issues. And we can’t ignore the bias and stigmatization that patients internalize, so we have a psychological overlay of obesity with disordered eating. That is all in addition to diabetes.”

Earlier trials in patients without diabetes showed that both semaglutide and tirzepatide can achieve more than 15% weight loss in patients with obesity, he continued. SURMOUNT 1, for example, showed a 15% weight loss with 5 mg weekly, 19.5% for 10 mg, and 20.9% for 15 mg.

Diabetes patients lose less weight than patients without diabetes, Dr. Garvey noted.

“These results help us get our heads around the idea that patients who have both obesity and type 2 diabetes have two diseases,” he said. “And each of those diseases wants optimal therapy. Everyone who treats patients with both obesity and type 2 diabetes needs to come to this symposium to see what a medication that is really targeted to weight loss can do for obesity as well as for diabetes.”