A new study has found that patients with type 2 diabetes who are not reaching their blood sugar goals on dulaglutide can benefit more by switching to tirzepatide rather than increasing their dulaglutide dose.
The study was published on April 4 in the Annals of Internal Medicine and presented at the Internal Medicine Meeting 2025 in New Orleans.
Type 2 diabetes is a long-term condition where the body struggles to manage blood sugar levels. People with this condition often need medication to help keep their blood sugar in a healthy range.
Dulaglutide and tirzepatide are both injectable medications taken once a week that help lower blood sugar and support weight loss. However, this study explored what happens when dulaglutide isn’t working well enough.
Researchers, led by Dr. Liana K. Billings from the University of Chicago, ran a clinical trial at several medical centers.
They studied 828 adults with type 2 diabetes who had been on dulaglutide for at least six months but still had high blood sugar levels, with hemoglobin A1c (HbA1c) readings between 7.0% and 9.5%. HbA1c is a common test that shows average blood sugar levels over the past three months.
Participants were randomly divided into two groups. One group switched to tirzepatide, while the other group stayed on dulaglutide but increased the dose—up to 4.5 mg per week or the highest dose they could tolerate. Both groups were followed for 40 weeks.
By the end of the study, those who switched to tirzepatide had much better results. On average, their HbA1c dropped by 1.44 percentage points, compared to just 0.67 points in the dulaglutide group.
Weight loss was also more impressive with tirzepatide—participants lost an average of 10.5 kilograms (about 23 pounds), while those who stayed on dulaglutide lost 3.6 kilograms (about 8 pounds).
In terms of safety, serious side effects were rare and occurred at similar rates in both groups (about 7%). The most common side effects were nausea and diarrhea.
The authors concluded that once-weekly tirzepatide led to “significantly greater” improvements in both blood sugar control and weight loss compared to continuing dulaglutide at a higher dose.
This study highlights an important option for people with type 2 diabetes who are already using dulaglutide but not seeing enough results. It suggests that changing to tirzepatide could offer much better outcomes, especially in lowering blood sugar and helping with weight loss, which is a key part of managing type 2 diabetes.
It’s important to note that the study was funded by Eli Lilly, the company that makes tirzepatide. While this doesn’t mean the results are biased, it’s something to keep in mind when evaluating drug research.
Overall, the findings support tirzepatide as a strong next step for people not getting the results they need from dulaglutide alone. It gives doctors and patients another option to consider when adjusting treatment plans for better health outcomes.
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The research findings can be found in Annals of Internal Medicine.
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