Twin Cretins as Potential Therapy for Type 2 Diabetes Mellitus; Systematic Review

Abstract

Background: The global management of type 2 diabetes mellitus (T2D) presents ongoing challenges, including the need for strategies that reduce cardiovascular risk and manage metabolic comorbidities. Incretin hormones, specifically glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are integral to metabolic regulation, yet individuals with T2D exhibit diminished incretin responses. Tirzepatide, a novel GIP/GLP-1 receptor agonist, has emerged as a promising therapeutic option, combining the advantages of both incretin hormones in a single molecule to manage T2D.

Objective: This systematic review aims to evaluate the efficacy of tirzepatide as a twincretin therapy for T2D and its associated adverse effects reported in previous studies.

Methods: Utilizing PRISMA guidelines, a comprehensive literature search was conducted across four key databases (PubMed, SCOPUS, Web of Science, and Science Direct) for English-language publications on tirzepatide and its impact on T2D management. Inclusion and exclusion criteria guided the selection process, while data extraction focused on participant characteristics, clinical outcomes, and risk of bias assessment.

Results: The analysis included various studies highlighting tirzepatide's effects. It consistently demonstrated significant reductions in HbA1c levels, with studies reporting mean reductions ranging from 0.47% to 2.58%, and substantial average weight loss of 12.4 kg or more. Notably, tirzepatide surpassed traditional therapies such as semaglutide and insulin glargine, displaying superior glycemic control with a comparable safety profile—primarily mild gastrointestinal side effects.

Conclusion: Tirzepatide represents a transformative advancement in T2D management, offering robust improvements in glycemic control and weight reduction alongside beneficial metabolic effects. Its favorable safety profile positions it as a substantial first-line therapy option. Future research should focus on long-term effects and practical application across various patient populations to optimize treatment strategies and improve patient outcomes significantly.