Tirzepatide appears to be more effective than standard care in early type 2 diabetes
Researchers report that early treatment of type 2 diabetes with tirzepatide leads to greater improvements over 2 years in blood sugar, body weight, and waist size than treatment with intensified standard care (ICC).
The SURPASS-EARLY study was published on May 25,2026 in the Annals of Internal Medicine.
“In participants with early T2D uncontrolled with metformin, tirzepatide treatment resulted in superior reductions in HbA1c, weight, and waist circumference, and more participants achieved normoglycemia (HbA1c <5.7%) with tirzepatide than ICC after 2 years,” the authors said
The investigators enrolled 794 adults, all of whom had been treated for 4 years or less with metformin.
They treated the subjects with either tirzepatide (15 mg or maximum tolerated dose, n=397) or ICC (including GLP-1RAs but excluding tirzepatide,) used in clinical practice and supported by local treatment guidelines (n=396).
The primary objective was the demonstration of the noninferiority of tirzepatide to ICC for change in hemoglobin A1c (HbA1c) from baseline to 2 years.
Secondary objectives were the demonstration of the superiority of tirzepatide for change in HbA1c, weight, and waist circumference.
At 2 years, tirzepatide was superior to ICC for mean changes from baseline to 2 years in HbA1c (1.99 percentage points vs. 1.32 percentage points.)
The estimated treatment difference for weight loss was a significant 8.0 kg (P< 0.001). For waist circumference it was a significant 6.2 cm (P< 0.001.)
More participants achieved normal blood sugar (HbA1c <5.7%) with tirzepatide (60.2%) than with ICC (24.0%).
“Initiation of treatment with tirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist (GLP-1RA), early after a diagnosis of type 2 diabetes (T2D) may establish better and more durable glycemic control than current treatment approaches per guidelines and clinical practice,” the authors said.
