A novel type 2 diabetes treatment has been licensed for use in the United Kingdom. Tirzepatide, marketed as Mounjaro, could be available for prescription as early as 2024, depending on supply. Mounjaro is an injectable therapy that assists the body in controlling blood glucose (sugars) after meals as well as regulating appetite.
Research has shown that this drug is more effective at managing blood sugar levels and facilitating more substantial weight loss compared to the type 2 diabetes medications presently prescribed. Tirzepatide is derived from a protein structurally similar to GIP (glucose-dependent insulinotropic peptide), a hormone that triggers insulin release.
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However, what sets tirzepatide apart is its interaction with the receptors of another hormone known as GLP-1 (glucagon-like peptide 1), which also triggers insulin release. This distinction makes tirzepatide the first "dual-hormone agonist" (a medication that binds to and stimulates a hormone's receptor) sanctioned for managing type 2 diabetes. In contrast, Semaglutide (marketed as Ozempic) exclusively focuses on GLP-1.
Specialized cells in our small and large intestines produce hormones called GLP-1 and GIP. These hormones are released when blood glucose levels rise after a meal. Both GLP-1 and GIP have the effect of stimulating the pancreas to produce more insulin, thus reducing blood glucose levels. Additionally, they inhibit the production of glucagon, a hormone responsible for increasing glucose levels when they are too low. Dysregulation of post-meal glucose levels is believed to contribute to the development of type 2 diabetes.
GLP-1 also slows the rate at which the stomach empties, allowing us to feel fuller for longer. All of these, when combined, offer considerable effects on decreasing blood glucose levels. These side effects have also been linked to weight reduction.
The natural GIP and GLP-1 hormones in our body typically have a short-lived impact, lasting approximately two minutes. However, tirzepatide has altered these hormones' structure, slowing their degradation and extending their effectiveness, which now spans roughly five days. Consequently, tirzepatide only requires once-a-week administration.
Given that tirzepatide replicates the actions of two hormones, it's unsurprising that research studies have indicated its superior efficacy compared to semaglutide, which solely influences GLP-1.
A 40-week trial compared tirzepatide dosages of 5mg, 10mg, and 15mg (all of which are licensed for use) to 1mg of semaglutide. The study discovered that all tirzepatide doses were more efficient than semaglutide at lowering average blood sugar levels, with more than 80% of those treated with tirzepatide able to meet their glucose targets.
It's worth noting that a separate year-long study has confirmed that 15mg of tirzepatide is just as effective as insulin in controlling blood glucose levels. This finding is significant because a majority of people living with type 2 diabetes are either overweight or obese. Until recently, treatment options for this disease did not promote weight loss and were even associated with weight gain.
However, drugs like tirzepatide and semaglutide have transformed our approach to treating type 2 diabetes by simultaneously lowering blood glucose and promoting weight loss. Research shows that people taking tirzepatide for type 2 diabetes lost an average of 8.5% - 13% of their body weight, which is more than those taking semaglutide.
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Moreover, weight loss can support diabetes management and even lead to remission. Having a higher body weight, especially weight carried around the middle, can result in insulin becoming less effective and being produced in smaller quantities. Therefore, tirzepatide is an effective option for managing type 2 diabetes. It can even be used safely alongside other diabetes drugs (like metformin) if diabetes control targets are not met.
There is compelling evidence to suggest that this might happen soon. Those who received tirzepatide lost 15-20% of their body weight in a big 72-week study of obese adults without diabetes. Only 3.1% of the placebo group dropped their body weight.
In another extended study, it was discovered that a once-weekly injection of tirzepatide led to an average 20% reduction in body weight for individuals who were overweight but not afflicted with type 2 diabetes. While no direct comparisons have been made between tirzepatide and semaglutide, these weight loss results surpass those seen in studies that used semaglutide.
However, while tirzepatide has the potential to be used as a weight control medication, it has not yet been licensed for that purpose in the United Kingdom, Europe, or the United States. It is currently only approved for the treatment of type 2 diabetes.
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