GLP-1 drugs were approved for the treatment of diabetes on the strength of large studies showing that they significantly lowered blood sugar levels.
In one major trial, weekly 0.5 milligram (mg) and 1 mg doses of semaglutide over the course of 30 weeks helped lower the A1C of participants with type 2 diabetes by 1.45 percent and 1.55 percent, respectively. They didn’t receive any other diabetes treatment, and their average starting A1C was around 8 percent.
A second trial tested a weekly 2 mg semaglutide dose against a weekly 1 mg dose in participants with poorly controlled diabetes (with an average A1C starting at 8.9 percent) over 40 weeks. The 2 mg dose reduced participants’ A1C by an average of 2.2 percentage points, while the 1 mg dose led to an average A1C decrease of 1.9 percentage points.
Meanwhile, a key trial for tirzepatide found that the dual GIP/GLP-1 medication performed even better than semaglutide in lowering A1C by 2.01, 2.24, and 2.3 percentage points with weekly 5 mg, 10 mg, and 15 mg doses.
Another 40-week trial indicated that a weekly 15 mg dose of tirzepatide reduced A1C by up to 2.07 percentage points and body weight by up to 9.5 kilograms (kg), which is equivalent to 20.9 pounds (lb). It also noted that tirzepatide brought average two-hour postmeal glucose levels below 140 mg/dL, a threshold considered normal in healthy people without diabetes.
“What’s important from a metabolic standpoint is that improvements are closely tied to meaningful weight loss and improved insulin resistance, reinforcing that we are increasingly treating type 2 diabetes as part of a broader chronic metabolic disease driven by excess adiposity [body fat],” says Abdelmasih.
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