Timothy Garvey, MD: Drivers of Differences in Weight Loss with Incretins Based on Diabetes Status

Published on: 

Details of an analysis from ADA 2024 compared matched cohorts from SURMOUNT-1 and SURMOUNT-2 to determine drivers of differences in weight loss from the trials.

An analysis of the SURMOUNT 1 and 2 trials presented at the 84th American Diabetes Association Scientific Sessions offers further insight into the differences in weight loss observed among people with and without type 2 diabetes achieved with use of tirzepatide.

Results of the study, which leveraged propensity score matching and mixed models for repeated measures (MMRM) analysis to compare the effect of Eli Lilly and Company’s dual GIP/GLP-1 receptor agonist in those with overweight or obesity based on diabetes status, suggest the differences in weight reductions observed persisted after matching key baseline characteristics, which investigators purport indicates other contributing factors drive these differences.

The current study was led by Rodolfo Galindo, MD, of Emory University, to better understand potential drivers of the difference in effects seen with tirzepatide on body weight reductions in people with overweight or obesity with or without type 2 diabetes. With this in mind, investigators designed their study to use propensity score matched cohorts, with matching based on age, gender, weight, BMI, antidepressant use or depression, and obesity-related comorbidities, in MMRM analysis to compare the percent of weight reduction achieved at week 72 between those with and without type 2 diabetes form within SURMOUNT-1 and SURMOUNT-2.

Investigators pointed out initial analysis of the cohorts revealed those in SURMOUNT-2 were older, had a greater proportion of more males, lower weight, greater HbA1c, and greater comorbidity burden compared to their counterparts in SURMOUNT-1.

Results of the ADA 2024 study indicate the differences in weight reduction observed at week 72 remained even after propensity score matching, with those in the SURMOUNT-1 cohort achieving greater levels of body weight reduction than their counterparts in SURMOUNT-2 with type 2 diabetes.

For more on the study, check out our interview with study investigator W. Timothy Garvey, MD, director of the Diabetes Research Center at the University of Alabama - Birmingham.

Relevant disclosures for Dr. Garvey include Boehringer-Ingelheim, Novo Nordisk, Eli Lilly and Company, Merck & Co., Inc., Alnylam Pharmaceuticals, Inc., Fractyl Health, Inc., Inogen, Epitomee, Pfizer Inc., and Neurovalens.


  1. Galindo RJ, Garvey WT, Neff LM, Stefanski A, Cao D, Lee C. Differences in Weight Reduction Efficacy of Tirzepatide in Adults Without vs. With Type 2 Diabetes with Overweight or Obesity in SURMOUNT 1 and 2. Presented at: American Diabetes Association (ADA) 84th Scientific Sessions. June 21 - 24, 2024. Orlando, FL.