Diabetologie und Stoffwechsel 2025; 20(S 01): S44-S45
DOI: 10.1055/s-0045-1807442
Abstracts | DDG 2025
Poster
Posterwalk 5: Diabeteskomplikationen I Niere I Fuß

Clinical Factors Associated with Insulin Regression When Adding Tirzepatide in Basal Insulin–Treated Type 2 Diabetes

C Wysham
1   Rockwood Clinic, Department of Diabetes and Endocrinology, Spokane, United States
,
J Rosenstock
2   Velocity Clinical Research at Medical City, Senior Scientific Advisor Velocity Clinical Research; Director Velocity Clinic at Medical City Dallas; Clinical Professor of Medicine, Univ. of Texas Southwestern Medical Center, Dallas, Texas, United States
,
S Tofé
3   University Hospital Son Espases, Department of Endocrinology and Nutrition, Palma, Spain
,
V Thieu
4   Eli Lilly and Company, Cardiometabolic Health, Indianapolis, United States
,
J Kiljanski
4   Eli Lilly and Company, Cardiometabolic Health, Indianapolis, United States
,
C Lee
5   Eli Lilly and Company, Global Medical Affairs Obesity/NILEX, Indianapolis, United States
,
H Wang
6   TechData Service Company LLC, TechData Service Company LLC, Philadelphia, United States
,
H Patel
7   Eli Lilly and Company, Type 2 Diabetes Development, Indianapolis, United States
,
T Schaum
8   Diabetologische Schwerpunktpraxis, Oldenburg in Holstein, Germany, Diabetologische Schwerpunktpraxis, Holstein, Germany
› Author Affiliations
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Given that basal insulin dose decreased over time, and up to 19% of tirzepatide (TZP)-treated participants discontinued basal insulin by Week 52 in SURPASS-6, what clinical parameters were associated with insulin regression (use<10 IU/day) at Week 52?

Methods: In SURPASS-6, TZP was added to basal insulin glargine in participants with inadequately controlled type 2 diabetes (T2D). Analyses included participants receiving TZP at Week 52 (≥75% adherence) without rescue medication. The outcome was basal insulin discontinuation or<10 IU/day use at Week 52 (“insulin regressor group”) or≥10 IU/day use at Week 52 (“insulin non-regressor group”). Association between the outcome and baseline variables was assessed by univariate logistic regression. Variables with p<0.2 entered stepwise multivariate logistic regression.

Results: A total of 145 and 496 participants were included in the insulin regressor and insulin non-regressor groups, respectively. Overall, 34.2%, 33.9%, and 32.0% of participants were on TZP 5 mg, 10 mg, and 15 mg, respectively. At baseline, mean age was 58.2 years; 59.3% were female; median insulin daily use was 46 IU; and mean fasting serum glucose (FSG) was 158 mg/dL. In the multivariate analysis, baseline factors associated with insulin regression were (odds ratio [OR] [95% CI]): TZP 10 mg vs. 5 mg: 1.84 (1.08-3.13), p=0.024; TZP 15 mg vs. 5 mg: 3.78 (2.25-6.35) p<0.001; female vs. male: 1.74 (1.14-2.67), p=0.011; daily insulin dose (by 1 SD decrease: 1.76 [1.36-2.27], p<0.001); and FSG (by 1 SD decrease: 1.38 [1.08-1.75], p=0.01). Some of the baseline factors not associated with insulin discontinuation or reduction were duration of diabetes, HbA1c, triglycerides, and eGFR.

Conclusion: Several clinical factors were associated with basal insulin regression in SURPASS-6, including higher randomized TZP dose, lower insulin daily dose, and lower FSG at baseline.



Publication History

Article published online:
28 May 2025

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