225-OR: The Effect of Tirzepatide vs. Insulin Degludec on Post-meal Glucose Control in Patients with Type 2 Diabetes (SURPASS-3 CGM)

Abstract

Tirzepatide (TZP) is a GIP/GLP-1 receptor agonist approved for treatment of patients with type 2 diabetes (T2D). This post-hoc analysis evaluated the impact of TZP vs insulin degludec (IDeg) on post-meal glucose control. In this sub-study of the 52-week open label, parallel arm, Phase 3, SURPASS-3 trial, 243 insulin naive adults with T2D (mean age 57 years; T2D duration 8.8 years, HbA1c 8.15%), were randomised (1:1:1:1 to receive weekly TZP 5, 10, 15 mg or titrated IDeg daily). Interstitial glucose values were collected by continuous glucose monitor (CGM) for approx. 7-10 days at baseline and 52 weeks. The 5-hour post-prandial period (PPP) was defined after meals detected via a validated algorithm. The impact of TZP 5, 10, and 15mg vs IDeg on interstitial glucose post meal from area under the curve (AUC) and peak post prandial glucose (PPG) at 52 weeks were assessed. PPG excursions were decreased with all doses of TZP as seen by less AUC >140 mg/dL and >180 mg/dL vs IDeg (Fig). All TZP doses spent significantly less time > 140mg/dL during the PPP 0-5 hrs (135, 96, and 99 mins for TZP 5, 10, and 15mg) vs IDeg (171 mins; p=0.051, p<0.001, p<0.001 respectively). All TZP doses had significantly lower peak PPG at 52 weeks vs IDeg (180.4 ± 4.45 mg/dL, 163.2 ± 4.97 mg/dL, 168.5 ±4.38 mg/dL vs 198.6± 4.98mg/dL respectively, p<0.001). All 3 doses of TZP led to improved AUC and reduced peak PPG vs IDeg as assessed by CGM. Disclosure T.Battelino: Advisory Panel; Eli Lilly and Company, Novo Nordisk, Sanofi, Medtronic, Abbott Diabetes, Consultant; Indigo Diabetes, Research Support; Novo Nordisk, Sanofi, Medtronic, Novartis, Speaker's Bureau; Eli Lilly and Company, Novo Nordisk, Sanofi, Medtronic, Abbott Diabetes, Dexcom, Inc. J.Johnson: Employee; Eli Lilly and Company. M.Katz: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. R.Bray: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. J.Xue: Employee; Eli Lilly and Company. K.Brown: Employee; Eli Lilly and Company. Funding Eli Lilly and Company