1-year outcomes of semaglutide, tirzepatide, and sleeve gastrectomy in obesity in type 2 diabetes: a retrospective cohort study.
Tirzepatide helps more people with both obesity and type 2 diabetes reach weight and blood sugar targets than semaglutide in real-world care.
In the largest real-world head-to-head comparison of modern obesity/T2D treatments using Epic Cosmos EHR data (n=45,093), tirzepatide achieved 13.2% composite weight/glycaemic target vs 3.0% for semaglutide, while sleeve gastrectomy led at 24.0%, though with higher ED visits. This directly informs treatment selection for physicians managing high-BMI T2D patients across the full range of available interventions.
What the study was
- Study design
- Retrospective cohort (EHR-based, Epic Cosmos)
- Population
- Adults with BMI ≥35 kg/m² and HbA1c >6.4%, receiving ≥12 months semaglutide, tirzepatide, or sleeve gastrectomy
- Sample size
- 45093
- Category
- Treatment Innovation
- Maturity
- Validated
- Journal
- Lancet Diabetes Endocrinol
Why it surfaced
Largest real-world head-to-head comparison of semaglutide vs tirzepatide vs bariatric surgery in T2D/obesity (n=45,093, Epic Cosmos, 1633 hospitals). Tirzepatide showed 4.4× higher composite target attainment vs semaglutide. Directly practice-relevant given rapid uptake of both agents.
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