Real-World Effectiveness of Tirzepatide versus Semaglutide on HbA1c and Weight in Patients with Type 2 Diabetes

Oct 9, 2025Diabetes therapy : research, treatment and education of diabetes and related disorders

Tirzepatide versus Semaglutide effects on blood sugar and weight in people with type 2 diabetes

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Abstract

Tirzepatide resulted in greater mean reductions in HbA1c and weight compared to semaglutide after 12 months.

  • In patients who had not previously used GLP-1 receptor agonists, those on tirzepatide experienced a mean HbA1c reduction of -1.3%, compared to -0.9% for those on semaglutide.
  • Patients with prior GLP-1 receptor agonist use on tirzepatide had a mean HbA1c reduction of -0.9%, while those on semaglutide saw a reduction of -0.6%.
  • Weight loss after 12 months was greater in the tirzepatide group, with a mean reduction of -10.2 kg in naïve patients versus -6.1 kg in semaglutide patients.
  • Non-naïve patients on tirzepatide lost an average of -7.9 kg, compared to -3.7 kg for those on semaglutide.
  • Both findings were statistically significant (p < 0.001).

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Key numbers

-1.3%
HbA1c Reduction (Naïve)
Mean change in HbA1c for tirzepatide vs. semaglutide
-10.2 kg
Weight Loss (Naïve)
Mean weight reduction for tirzepatide vs. semaglutide
-0.9%
HbA1c Reduction (Non-Naïve)
Mean change in HbA1c for tirzepatide vs. semaglutide

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