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Tirzepatide improved quality of life more than insulin lispro in adults with type 2 diabetes already using basal insulin and with poor blood sugar control
Among 1428 participants with type 2 diabetes, those receiving tirzepatide showed statistically significant improvements in compared to those treated with insulin lispro at 52 weeks.
Participants in the tirzepatide group had better scores in all domains of the Short Form-36 Health Survey version 2 compared to the insulin lispro group.
The most notable improvements in health-related quality of life were observed in general health, vitality, and mental health domains.
Tirzepatide-treated participants also experienced significant enhancements in daily living activities and self-perception related to weight.
Higher scores were recorded in the EQ visual analogue scale and EQ-5D-5L index for those receiving tirzepatide after adjusting for baseline measurements.
Overall, tirzepatide treatment is associated with improved health-related quality of life and glycaemic control compared to prandial insulin therapy.
Simplified
INTRODUCTION: Patients with type 2 diabetes (T2D) who require intensification of basal insulin therapy need treatment options that can improve their (HRQoL) and translate into better outcomes. These analyses compared patient-reported outcomes (PROs) in patients with T2D receiving tirzepatide or insulin lispro.
METHODS: The randomised, open-label, multinational, phase 3b SURPASS-6 trial (NCT04537923) was conducted at 135 medical research centres and hospitals in 15 countries and compared two recommended treatment intensification strategies in people with T2D and inadequate glycaemic control on basal insulin: addition of once-weekly tirzepatide versus addition of prandial insulin lispro. Randomisation was stratified by country, baseline glycated haemoglobin level and metformin use. PROs were measured using the Short Form-36 Health Survey version 2 (SF-36v2) acute form (secondary outcome), EQ-5D-5L, Ability to Perform Physical Activities of Daily Living (APPADL) questionnaire and Impact of Weight on Self-Perceptions (IW-SP) questionnaire (tertiary/exploratory outcomes). PROs were compared for the tirzepatide-pooled dose group (5, 10 and 15 mg) and each tirzepatide dose group versus insulin lispro at 52 weeks using the modified intention-to-treat efficacy analysis set.
RESULTS: Between 19 October 2020 and 01 November 2022, 2267 people were assessed and 1428 participants with T2D were randomised. At 52 weeks, participants in the tirzepatide-pooled group had statistically significant improved scores across all SF-36v2 domains and both component summary scores compared with insulin lispro-treated participants (p < 0.05), with the largest differences observed in the general health, vitality and mental health domains. Statistically significant improved APPADL and IW-SP total scores, as well as EQ visual analogue scale and EQ-5D-5L index scores (after adjustment for baseline scores), were observed in tirzepatide-pooled participants compared with insulin lispro-treated participants.
CONCLUSIONS: In adult patients with T2D and inadequate glycaemic control with basal insulin, tirzepatide treatment was associated with greater improvements in HRQoL than prandial insulin therapy in addition to clinically significant improvements in glycaemic and body weight-related parameters.
Key numbers
p < 0.05
Improvement in
Comparison of SF-36v2 scores at 52 weeks between treatment groups.
67.5% of tirzepatide-pooled participants
target achievement
Proportion of participants meeting target of < 7.0% at 52 weeks.
−12.2 kg
Weight loss difference
Mean difference in weight change from baseline at 52 weeks.
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Kristina Secnik Boye, Jiat Ling Poon, Laura Fernandez Lando, Helene Sapin, Ruth Huh, and Hiren Patel are minor stockholders of Eli Lilly and Company. Mianbo Wang and Suzanne Williamson work as consultants for Eli Lilly and Company.
