What the trial was testing
The SURPASS-4 enrolled 2,002 patients with type 2 diabetes. The study was sponsored by Eli Lilly and tracked outcomes across the full group of patients who matched the trial's eligibility profile.
It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.
What the results showed
A1c dropped 1 full point more on tirzepatide vs. insulin glargine.
The Lancet · 2021 · NCT03730662
These findings — that on tirzepatide vs. insulin glargine over 52 weeks in high-cardiovascular-risk diabetes — were published in the The Lancet and represent the headline result of the study.
Researchers tracked outcomes across 2,002 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.
What this means for patients
For patients with type 2 diabetes, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.
What you can do now
Tirzepatide (Mounjaro for diabetes, Zepbound for weight loss) is FDA-approved and available now. It is a once-weekly injection. Most common side effects are nausea and stomach upset that ease over time. Ask your doctor if it fits your diabetes plan, especially if heart disease is a concern.
Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.
Open type 2 diabetes trials
Phase 2 Trial of Icovamenib in Participants With Type 2 Diabetes Mellitus Who Are Not Achieving Glycemic Targets While Using GLP-1-Based Therapy
This is a phase 2 randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of icovamenib in participants with Type 2 Diabetes (T2D) not achieving glycemic targets despite Ozempic-based therapy.
Bone Health After Bariatric Surgery in Patients With Type 2 Diabetes
Background: Bone fragility is a complication of type 2 diabetes. Diabetes treatments may ameliorate or deteriorate bone fragility in this population. Bariatric surgery is gaining in popularity in people with type 2 diabetes and may impact bone health. Objectives: To evaluate the impact of the most popular bariatric procedure worldwide (sleeve gastrectomy (SG)) on vBMD by QCT in patients with type 2 diabetes; Secondary aims: (1) to identify the determinants of vBMD after bariatric surgery in patients with type 2 diabetes; (2) to compare vBMD and its potential determinants after bariatric surgery with obese controls without diabetes as well as with controls without obesity and normoglycemia.