Tirzepatide represents a therapeutic advance in type 2 diabetes management because unlike semaglutide it is:
- A A dual GIP/GLP-1 receptor agonist (twincretin) combining incretin actions of both gut hormones at a single molecule ✓
- B A GLP-1 receptor agonist with additional SGLT2 inhibition via an allosteric mechanism
- C A selective GIP receptor agonist that has greater pancreatic beta-cell protective effects than GLP-1 agonists
- D A GLP-1 receptor agonist with additional glucagon receptor partial agonism to prevent hypoglycemia
Explanation
Tirzepatide is a synthetic 39-amino acid peptide that is a dual agonist at both GIP (glucose-dependent insulinotropic polypeptide) receptor and GLP-1 (glucagon-like peptide-1) receptor — hence the term 'twincretin.' GIP has additive insulinotropic effects and reduces glucagon secretion, while GLP-1 additionally delays gastric emptying and reduces appetite. SURPASS trials showed tirzepatide achieved greater HbA1c reduction and weight loss than semaglutide alone, with superior outcomes in head-to-head SURPASS-2 trial. SURMOUNT trials also established it for obesity management. It is not an SGLT2 inhibitor.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.