A Comparative Study Between Tirzepatide and Semaglutide in The Management of Obesity and Type 2 Diabetes Mellitus

Introduction: Obesity and type 2 diabetes mellitus (T2DM) are major public health concerns worldwide, requiring effective treatment strategies. Tirzepatide and Semaglutide are novel therapeutic agents that have shown efficacy in managing both conditions. This study aimed to compare the efficacy and metabolic outcomes of Tirzepatide versus Semaglutide in obese patients associated with T2DM. Methods: This retrospective observational study was conducted in the Department of Cardiology, Labaid Cancer Hospital & Super Speciality Centre, Labaid Diagnostics Center, Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh, from January 2023 to December 2023. In this study, we included 100 patients with obesity who attended the cardiology department of our institution. The patients were divided into two groups -Group A (Patients who were treated with Tirzepatide) and Group B (Patients who were treated with Semaglutide). Result: At baseline, the groups were comparable in age (31.73 ± 9.59 years for Tirzepatide vs. 32.96 ± 12.32 years for Semaglutide) and BMI (32.67 ± 6.24 kg/m² vs. 33.41 ± 5.47 kg/m², p = 0.529). By the third follow-up, the mean weight reduction was greater in the Tirzepatide group (77.32 ± 10.63 kg) compared to the Semaglutide group (79.24 ± 9.91 kg), with a statistically significant difference in the percentage reduction in weight (11.4% vs. 10.3%, p < 0.001). FBS and HbA1c levels also showed greater reductions in the Tirzepatide group, with significant differences at the third follow-up (FBS: 5.45 ± 0.41 mg/dl vs. 5.63 ± 0.32 mg/dl, p = 0.016; HbA1c: 4.6 ± 0.4% vs. 4.8 ± 0.3%, p = 0.005). Minor adverse effects were common in both groups, with nausea/vomiting being the most frequent (38% in Group A and 44% in Group B). Unique to the Tirzepatide group were injection site itching (32%) and feeling feverish (12%), while dizziness occurred only in the Semaglutide group (12%). Conclusion: The study findings show that both Tirzepatide and Semaglutide effectively reduced weight, BMI, FBS, and HbA1c in patients with obesity. Overall, Tirzepatide demonstrated a greater reduction in weight, BMI, fasting blood sugar, and HbA1c compared to Semaglutide, with a statistically significant advantage in (%) change in weight and FBS.