ABSTRACT
Introduction
Diabetes is a global public health challenge with rising prevalence. This review explores current diabetes understanding, diagnostic and management guidelines, economic impact, and lifestyle modifications as the primary approach.
Areas covered
Focusing on pharmacological interventions, we discuss the roles of GLP-1 agonists and GLP/GIP agonists in diabetes management and cardiovascular risk reduction. Tirzepatide, a novel medication, is highlighted for its unique mechanism of action. Clinical trials demonstrate its effectiveness in glucose control, weight reduction, and its potential impact on diabetes, obesity, NASH, and cardiovascular risks.
Expert opinion
Tirzepatide shows promise in diabetes treatment, offering glucose control and weight loss. It also holds potential for addressing comorbidities. However, cautious use is vital due to potential adverse effects and contraindications, including hypersensitivity reactions, pregnancy, and breastfeeding precautions. This review underscores tirzepatide as a valuable addition to diabetes therapies, with evolving prospects for enhanced patient outcomes as research advances.
Article highlights
The prevalence of diabetes has become a major public health concern worldwide, with approximately 10.5% of the US population affected by diabetes, and projections indicating over 12% of the world’s population affected by 2045.
The current pharmacological therapeutic options for managing Type 2 diabetes mellitus include lifestyle modifications, metformin, GLP-1 agonists, SGLT-2 inhibitors, and insulin, with GLP-1 agonists preferred over insulin in recent guidelines.
Tirzepatide is an investigational dual GLP-1/GIP receptor agonist that has shown promising results in reducing A1c levels, promoting weight loss, and reducing cardiovascular risk in individuals with type 2 diabetes.
Completed clinical trials of tirzepatide, such as SURPASS-1, SURPASS-2, SURPASS-3, SURPASS-4, and SURPASS-5, have demonstrated its efficacy in glycemic control, weight loss, and potential benefits in obesity and NASH.
Ongoing trials, including SURPASS-CVOT, SURPASS-EARLY, SURMOUNT-1, SURMOUNT-2, SURMOUNT-3, and SURMOUNT-4, aim to further explore tirzepatide’s cardiovascular outcomes, early intervention benefits, and weight loss maintenance or improvement in various patient populations.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.