Tirzepatide is as effective at treating early-onset type 2 diabetes as it is at treating type 2 diabetes diagnosed later in life, new research presented at EASD has found.
Tirzepatide belongs to a new class of drugs that mimic the effect of two hormones involved in blood sugar control and appetite suppression, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).
The drug, a once-weekly injection, was approved as type 2 diabetes treatment in the US in May 2022 and was recently given approval as a treatment for some people with type 2 diabetes in England.
Type 2 diabetes, the most common form of diabetes, usually occurs in middle-aged and older people. However, onset at a younger age is becoming more common globally. Young-onset type 2 diabetesor early-onset type 2 diabetes is more aggressive.
The insulin-producing beta cells in the pancreas deteriorate more quickly in people with early-onset type 2 diabetes than those with later-onset type 2 diabetes.
Evidence for this includes data from the SURPASS programme. In this series of clinical trials designed to assess tirzepatide’s potential as a treatment for type 2 diabetes, those with young-onset type 2 diabeteswere in worse overall health than those with later-onset type 2 diabetes.
Despite being younger, those with early-onset type 2 diabetes had higher blood sugar levels, higher mean body weight and BMI and higher levels of blood fats that increase the risk of cardiovascular disease, than those with later-onset type 2 diabetes.
Individuals with early-onset type 2 diabetes also respond less well to treatments. Despite this, there has been little research on the management of the condition.
Professor Melanie Davies, of the University of Leicester, Leicester UK, and colleagues in the US used data from the SURPASS programme to assess the effect of tirzepatide on glycaemic control, body weight and cardiometabolic markers in early-onset type 2 diabetes. Three different doses of tirzepatide were tested in SURPASS: 5mg, 10mg and 15mg.
The analysis compared changes in mean HbA1c (average blood sugar level), body weight and cardiometabolic markers including waist circumference (WC), lipids and blood pressure in participants with young-onset (N=873, 20.5%) and later-onset type 2 diabetes (N=3,394, 79.5%) after 40 or 52 weeks of treatment with tirzepatide.
Tirzepatide was found to be equally effective in young and later-onset type 2 diabetes. It led to similar improvements in HbA1c and body weight in young and later-onset type 2 diabetes at Week 40/52 at all three doses.
Tirzepatide (all doses) also improved waist circumference, lipids (triglycerides and HDL) and systolic blood pressure similarly in both groups.
Professor Davies concludes: “Early-onset type 2 diabetes is not only more aggressive, it usually responds less well to drugs, which means our findings are really encouraging.
“Further research is now needed to evaluate whether starting treatment with tirzepatide and similar drugs early improves long-term outcomes in this important group.”