{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:23:05Z","timestamp":1781850185281,"version":"3.54.5"},"reference-count":42,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>This post hoc analysis assessed sustainability of lowered glycated hemoglobin (HbA1c) and weight with tirzepatide in people with type 2 diabetes and increased cardiovascular risk. Participants achieving HbA1c \u226448 mmol\/mol (6.5%) or weight loss \u226510% at 52 weeks were evaluated for sustained glycemic or weight control and predictors of initial and sustained efficacy. For tirzepatide-treated participants achieving HbA1c \u226448 mmol\/mol (6.5%) at 52 weeks, 75\u201384% sustained this until study end (median 81 weeks). Factors predicting achievement were higher tirzepatide dose, shorter diabetes duration, and lower HbA1c, higher HOMA of \u03b2-cell function (HOMA-B), metformin alone, and absence of albuminuria at baseline. Factors predicting sustained glycemic control were greater weight loss, smaller fasting glucose decrease, no sulfonylurea, and higher HOMA-B at 52 weeks. For participants achieving \u226510% weight loss at 52 weeks, 79\u201382% maintained weight loss. Factors predicting achievement were higher tirzepatide dose, female sex, no cardiovascular disease history, and lower baseline HbA1c, estimated glomerular filtration rate, and triglycerides. Greater decrease in LDL-cholesterol to 52 weeks predicted maintained weight loss. Greater weight loss and better \u03b2-cell function achieved with tirzepatide were the main predictors for sustained glycemic control in this post hoc analysis; no clinically meaningful predictor was identified for sustained weight control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Article Highlights<\/jats:title>\n                    <jats:p>We aimed to explore sustainability of lowered glycated hemoglobin (HbA1c) and weight with tirzepatide in a post hoc analysis. The question we wanted to answer was what predicted achieving and sustaining HbA1c and weight reduction in A Study of Tirzepatide (LY3298176) Once a Week Versus Insulin Glargine Once a Day in Participants With Type 2 Diabetes and Increased Cardiovascular Risk (SURPASS-4). We found greater weight loss and improved \u03b2-cell function were the main predictors for sustained glycemic control with tirzepatide therapy. No clinically relevant predictor was identified for sustained weight loss. Simple clinical measures may predict initial and sustained glycemic control and initial weight loss with tirzepatide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/db25-0276","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T20:38:00Z","timestamp":1752093480000},"page":"1850-1862","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of Initial and Sustained Glycemic and Weight Response to Tirzepatide: A Post Hoc Analysis of SURPASS-4"],"prefix":"10.2337","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-8585","authenticated-orcid":false,"given":"Ewan R.","family":"Pearson","sequence":"first","affiliation":[{"name":"Division of Population Health & Genomics, School of Medicine, University of Dundee 1 , Dundee, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5388-0270","authenticated-orcid":false,"given":"Stefano","family":"Del Prato","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Center \u201cHealth Science,\u201d Sant\u2019Anna School of Advanced Studies 2 , Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2016-7049","authenticated-orcid":false,"given":"Imre","family":"Pavo","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company 3 , Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4961-0638","authenticated-orcid":false,"given":"Denise R.","family":"Franco","sequence":"additional","affiliation":[{"name":"CPCLIN\/DASA Clinical Research Center 4 , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company 3 , Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Nicolay","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company 3 , Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5856-5114","authenticated-orcid":false,"given":"Andrea","family":"Hemmingway","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company 3 , Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6705-7545","authenticated-orcid":false,"given":"Russell J.","family":"Wiese","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company 3 , Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7307-9002","authenticated-orcid":false,"given":"Steven E.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System and University of Washington 5 , Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"2026061114471726600_B1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1002\/(SICI)1096-9136(199804)15:4<290::AID-DIA570>3.0.CO;2-M","article-title":"Beta-cell deterioration determines the onset and rate of progression of secondary dietary failure in type 2 diabetes mellitus: the 10-year follow-up of the Belfast Diet Study","volume":"15","author":"Levy","year":"1998","journal-title":"Diabet Med"},{"key":"2026061114471726600_B2","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.2337\/diab.44.11.1249","article-title":"U.K. Prospective Diabetes Study 16: overview of 6 years' therapy of type II diabetes: a progressive disease","volume":"44","author":"U. 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