{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T18:51:13Z","timestamp":1781808673572,"version":"3.54.5"},"reference-count":15,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100013844","name":"Center for Clinical and Translational Science, University of Kentucky","doi-asserted-by":"publisher","award":["UL1TR001998"],"award-info":[{"award-number":["UL1TR001998"]}],"id":[{"id":"10.13039\/100013844","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate insulin dose requirements after the addition of the dual glucose-dependent insulinotropic polypeptide\/glucagon-like peptide 1 (GLP-1) receptor agonist tirzepatide compared with the GLP-1 receptor agonists injectable semaglutide and dulaglutide in people with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This was a retrospective cohort study using chart review of electronic health records to identify patients from a single academic medical center with type 2 diabetes who were initiated on tirzepatide, injectable semaglutide, or dulaglutide from 1 July 2021 to 31 May 2023 while on concomitant insulin therapy (basal with or without bolus or premixed insulin).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 135 patients were included in the study. The median percentage change in insulin requirement was 0% at 4\u20136 weeks (P = 0.286), \u221216.67% at 3 months (P &amp;lt;0.001), \u221251.03% at 6 months (P &amp;lt;0.001), and \u201358.33% at 12 months (P = 0.013) for the tirzepatide group (n = 45) and 0% at 4\u20136 weeks, 3 months, and 6 months and \u221212.50% at 12 months in the combined dulaglutide and semaglutide group (n = 90). Mean change in weight at 6 months was \u22128.5813 kg in the tirzepatide group and \u22123.4111 kg in the dulaglutide and semaglutide group (P &amp;lt;0.001). The most commonly reported adverse events in the tirzepatide group were decreased appetite, nausea, and vomiting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In patients with type 2 diabetes who were also on insulin, tirzepatide led to significantly lower insulin requirements after 3, 6, and 12 months of use compared with dulaglutide and semaglutide. Tirzepatide also led to significantly more weight loss compared with dulaglutide and semaglutide and yielded a larger decrease in A1C overall without increasing side effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/ds24-0035","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T10:38:11Z","timestamp":1740047891000},"page":"266-273","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of Insulin Dosage After the Addition of Tirzepatide Compared With Semaglutide or Dulaglutide in Patients With Type 2 Diabetes"],"prefix":"10.2337","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3888-5275","authenticated-orcid":false,"given":"Delaney B.","family":"McKone","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare 1 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolyn S.","family":"Duprey","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare 1 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley M.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare 1 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Leonhard","sequence":"additional","affiliation":[{"name":"Statistician, University of Kentucky College of Pharmacy 2 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aric","family":"Schadler","sequence":"additional","affiliation":[{"name":"Statistician, University of Kentucky College of Pharmacy 2 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4738-3785","authenticated-orcid":false,"given":"Kristina W.","family":"Naseman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare 1 , Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"2026061813515720600_B1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1056\/NEJMoa2107519","article-title":"Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes","volume":"385","author":"Fr\u00edas","year":"2021","journal-title":"N Engl J Med"},{"key":"2026061813515720600_B2","doi-asserted-by":"crossref","first-page":"14631","DOI":"10.3390\/ijms232314631","article-title":"Tirzepatide: a systematic update","volume":"23","author":"Forzano","year":"2022","journal-title":"Int J Mol Sci"},{"key":"2026061813515720600_B3","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.1111\/dom.14117","article-title":"Semaglutide once weekly in people with type 2 diabetes: real-world analysis of the Canadian LMC diabetes registry (SPARE study)","volume":"22","author":"Brown","year":"2020","journal-title":"Diabetes Obes Metab"},{"issue":"1","key":"2026061813515720600_B4","first-page":"S11","article-title":"Improving care and promoting health in populations: Standards of Care in Diabetes\u20142024","volume":"47","author":"ElSayed","year":"2024","journal-title":"Diabetes Care"},{"key":"2026061813515720600_B5","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1210\/jc.2018-00070","article-title":"Semaglutide added to basal insulin in type 2 diabetes (SUSTAIN 5): a randomized, controlled trial","volume":"103","author":"Rodbard","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2026061813515720600_B6","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1093\/ajhp\/zxac046","article-title":"Real-world evaluation of insulin requirements after GLP1 agonist or SGLT2 inhibitor initiation and titration","volume":"79","author":"George","year":"2022","journal-title":"Am J Health Syst Pharm"},{"key":"2026061813515720600_B7","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1007\/s40265-014-0325-2","article-title":"Combining a GLP-1 receptor agonist and basal insulin: study evidence and practical considerations","volume":"74","author":"Carris","year":"2014","journal-title":"Drugs"},{"key":"2026061813515720600_B8","volume-title":"Ozempic [package insert].","author":"Novo Nordisk","year":"2022"},{"key":"2026061813515720600_B9","volume-title":"Trulicity [package insert].","author":"Eli Lilly and Company","year":"2020"},{"key":"2026061813515720600_B10","volume-title":"Mounjaro [package insert].","author":"Eli Lilly and Company","year":"2022"},{"key":"2026061813515720600_B11","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0140-6736(19)31149-3","article-title":"Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial","volume":"394","author":"Gerstein","year":"2019","journal-title":"Lancet"},{"key":"2026061813515720600_B12","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and cardiovascular outcomes in patients with type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N Engl J Med"},{"key":"2026061813515720600_B13","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med"},{"key":"2026061813515720600_B14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ahj.2023.09.007","article-title":"Comparison of tirzepatide and dulaglutide on major adverse cardiovascular events in participants with type 2 diabetes and atherosclerotic cardiovascular disease: SURPASS-CVOT design and baseline characteristics","volume":"267","author":"Nicholls","year":"2024","journal-title":"Am Heart J"},{"key":"2026061813515720600_B15","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1001\/jama.2022.0078","article-title":"Effect of subcutaneous tirzepatide vs placebo added to titrated insulin glargine on glycemic control in patients with type 2 diabetes: the SURPASS-5 randomized clinical trial","volume":"327","author":"Dahl","year":"2022","journal-title":"JAMA"}],"container-title":["Diabetes Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/spectrum\/article-pdf\/38\/3\/266\/800190\/diaspectds240035.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/spectrum\/article-pdf\/38\/3\/266\/800190\/diaspectds240035.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:52:05Z","timestamp":1781805125000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/spectrum\/article\/38\/3\/266\/157921\/Evaluation-of-Insulin-Dosage-After-the-Addition-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2,20]]},"published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.2337\/ds24-0035","relation":{},"ISSN":["1040-9165","1944-7353"],"issn-type":[{"value":"1040-9165","type":"print"},{"value":"1944-7353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]}}}