Type 2 Diabetes: Top Papers in 2022

First-in-Class Tirzepatide Wins FDA Approval for Treatment of Type 2 Diabetes

Tirzepatide, a novel once-weekly GLP-1/GIP mimetic that binds to receptors and stimulates glucose-dependent insulin release, has shown superiority over many common antihyperglycemics.

Across the SURPASS clinical trial program, patients who received once-weekly tirzepatide 15 mg (the maximum recommended dose) achieved mean reduction in HbA1c 1.6% greater than patients taking placebo when the dual incretin agonist was used as monotherapy and 1.5% greater vs placebo when added to treatment with a long-acting insulin analog.

Investigational Glucagon Receptor/GLP-1 Receptor Dual Agonist Bests Semaglutide for Weight Loss in T2D Patients

An investigational glucagon receptor (GCGR)/glucagon-like peptide-1 (GLP-1) receptor co-agonist was associated with greater dose-dependent loss of body weight in patients with type 2 diabetes (T2D) when compared to placebo and to the GLP-1 receptor analogue semaglutide, according to findings reported during ObesityWeek® 2022.

Julio Rosenstock, MD, and colleagues report that the GCGR/GLP-1 receptor dual agonist in a previous study reduced HbA1c in a dose-dependent manner in patients T2D receiving stable metformin therapy but not at goal. The investigators report here on dose-dependent bodyweight reductions with the GCGR/GLP-1 R dual agonist in the same cohort

Novel Once-Weekly Insulin Icodec Found Superior vs Insulin Degludec in Reducing HbA1c in Type 2 Diabetes

Novel, once-weekly insulin icodec demonstrated superior reduction in HbA1c compared to insulin degludec in persons with T2D, according to new findings from the 6-study ONWARDS clinical development program.

The new results are from ONWARDS 2, a phase 3a, 26-week efficacy and safety treat-to-target study analyzing how well once-weekly insulin icodec controls blood sugar compared to once-daily insulin degludec in 526 participants with T2D. Results showed that from an overall baseline HbA1c of 8.13%, once-weekly insulin icodec achieved a superior reduction in estimated HbA1c of 0.93% compared to 0.71% for insulin degludec (estimated treatment difference: -0.22%).

Early-onset Type 2 Diabetes Linked to Significantly Increased Risk for CVD in Later Life: Study

Among patients diagnosed with T2D before age 40 years, investigators found a more than 5-fold increase in risk for both all-cause and CV mortality compared to a matched control group without T2D.

In addition to significantly increased risk for death from CV or any cause, the researchers also found that those with early-onset T2D were 7 times more likely to be hospitalized with heart failure than the matched controls.

Semaglutide 2.4 mg Reduces 10-year Risk of T2D in Patients with Overweight, Obesity

In patients with overweight or obesity, once-weekly semaglutide 2.4 mg reduced the 10-year risk of developing T2D by approximately 60%, according to new phase 3 clinical trial findings. The risk reduction was consistent regardless of initial glycemic status and sustained treatment was required to maintain the benefit.

Semaglutide, a SGLT-2 inhibitor, combined with diet and exercise, was assessed for chronic weight management against placebo in the phase 3 STEP clinical trial program which was the foundation for the US Food and Drug Administration approval awarded for that purpose in June 2021.

Low-carbohydrate Diet Could Help Improve Untreated HbA1c of 6.0% to 6.9%

Among adults with prediabetes and untreated diabetes, following a low-carbohydrate diet led to a significant decrease in hyperglycemia, fasting plasma glucose, and body weight at 6 months, according to research from investigators at Tulane University.

The study authors say the findings suggest “that a low-carbohydrate diet, if sustained, might be a useful dietary approach for preventing and treating type 2 diabetes,” but caution that additional research is needed.