Blood
Type 2 diabetes: Adding Mounjaro to insulin may aid weight loss
Oct
- About half of all people with diabetes do not know they have it.
- However, uncontrolled type 2 diabetes may lead to potentially serious health issues.
- Researchers have now found that adding Mounjaro to insulin treatments not only helps lower average blood sugar levels but also provides more weight loss and less hypoglycemia in people with uncontrolled type 2 diabetes.
As of 2021, an estimated 537 million people globally have diabetes. Of that number, about 96% of them have type 2 diabetes — a type of diabetes where the body no longer uses insulin correctly.
However, many times, people with type 2 diabetes are not aware they have it. Previous research estimates that almost half of all people with diabetes are undiagnosed.
Uncontrolled type 2 diabetes can lead to potentially serious health complications, including heart disease, kidney damage, nerve damage, and vision loss.
Now, researchers from Velocity Clinical Research at Medical City in Dallas, Texas, say adding tirzepatide — marketed under the brand name Mounjaro — to insulin treatments helps lower average blood sugar levels and provides more weight loss and less hypoglycemia in people with uncontrolled type 2 diabetes.
This study was recently published in the journal JAMA.
In this study, researchers conducted a randomized clinical trial with about 1,400 participants with inadequately controlled type 2 diabetes treated with basal insulin.
Basal insulin is a slow-acting type of insulin that people with diabetes may take between meals to help control their blood sugar levels when not eating.
Study participants were randomly selected to either receive injections of Mounjaro once a week or a prandial — taken during a meal — premix of insulin lispro three times a day.
Upon analysis, scientists discovered study participants who received Mounjaro decreased their hemoglobin A1C (HbA1c) test levels, which measures a person’s average blood sugar level over the last three months, compared to those who took the prandial insulin.
Additionally, study participants taking Mounjaro had more weight loss and fewer hypoglycemic events than those given the insulin lispro.
After reviewing this study, Dr. Pouya Shafipour, a board certified family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, California, told Medical News Today he was not shocked by these findings.
“I’ve been using Mounjaro since it got approved and I’m not surprised it’s very effective in managing diabetes,” he continued. “We’ve been pleasantly surprised with the results.”
“It is great news that there is an alternative to insulin to obtain glycemic control especially when it causes weight loss rather than weight gain that occurs with insulin,” Dr. Jennifer Cheng, chief of endocrinology at Hackensack Meridian Jersey Shore University Medical Center told Medical News Today when asked about her first reaction to this study.
“We have seen this in the clinical environment with significant weight loss for our diabetic patients,” she said.
Mounjaro for diabetes
“The GLP-1 class of medications has really transformed the treatment of type 2 diabetes. We have seen significant amounts of weight loss with our diabetic patients. Losing weight and losing insulin resistance will therefore improve sugar control.”
— Dr. Jennifer Cheng
Mounjaro is the brand name of an injectable medication called tirzepatide, only available by prescription. A person prescribed Mounjaro has to give themselves injections at home.
It was approved by the U.S. Food and Drug Administration (FDA) in May 2022 as a treatment for helping improve blood sugar control in adults with type 2 diabetes.
Mounjaro is currently the only medication that is both a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.
Similar medications like Ozempic and Wegovy are only GLP-1 receptor agonists.
Both GIP and GLP-1 are primary incretin hormones secreted by the intestine when you eat something containing sugar or any other ingredient that stimulates the secretion of insulin by the pancreas.
Mounjaro mimics these two hormones and signals the pancreas to increase its insulin production and stop the liver from producing more sugar. It also heightens the body’s sensitivity to insulin. All of these together help improve the body’s blood sugar control.
Additionally, Mounjaro causes you to feel full sooner when eating, as well as staying full for a longer period of time, potentially assisting with weight loss.
A study presented this past October at the European Association for the Study of Diabetes annual meeting reported that Mounjaro was more effective for both weight loss and blood sugar management than Ozempic and Wegovy.
For people with type 2 diabetes who are considering trying a medication like Mounjaro or Ozempic, what do they need to know when making a decision?
First off, Dr. Shafipour said people should understand these are medications that require them to deliver injections to themselves at home, so they must be comfortable with that. And he said when prescribing, doctors need to make sure there are no contraindications.
“The biggest contraindication is if someone is at risk of medullary thyroid cancer based on their family history — it’s a pretty rare form of thyroid cancer,” he detailed.
Who can’t be prescribed Mounjaro
“[If people have] multiple endocrine neoplasia type 2 in their family history, then we can’t prescribe [Mounjaro]. Also, if people are at risk of developing pancreatitis or pancreas inflammation, these drugs can cause that.”
— Dr. Pouya Shafipour
Dr. Cheng said people should know about the potential side effects of these types of medications — including nausea, vomiting, diarrhea, slowing of the gut, and potential for pancreatitis. And people should also factor in the cost of the medications.
“There is a cost consideration for this medication. While there are significant benefits for the medication, there is also a high cost, which is often covered by medical insurance,” she continued.
Not yet approved for weight loss
“I would also like patients to know that this medication is not approved for weight loss at this time. Most insurance companies require a diagnosis of type 2 diabetes for coverage. For non-diabetic patients, there is an alternative to [Mounjaro] called Wegovy. Patients will need a weight loss benefit in their insurance to obtain coverage for obesity medication.”
— Dr. Jennifer Cheng
