Zepbound Reduces Diabetes Progression Risk by 94%,

Prediabetes occurs when a person’s average blood sugar level is higher than the normal range, but not high enough to be diagnosed as diabetes. It’s a major risk factor in the development of type 2 diabetes and a tricky condition to treat because it often doesn’t show any signs. If symptoms do appear, they’re often overlooked because they don’t significantly disrupt daily life.

Some people are unaware that they have prediabetes until the condition progresses to diabetes. Fortunately, a recent study by Eli Lilly has found that Zepbound — an incretin medication approved for obesity — can delay the onset of type 2 diabetes in people with prediabetes. Will this change the trajectory of the diabetes epidemic in the U.S.? Will the FDA approve Zepbound for the treatment of prediabetes?

The Need for Expanded Prediabetes Care

Diabetes cases in the U.S. continue to rise because the rates of prediabetes and obesity also increase. Based on the statistics published by the American Diabetes Association from various studies, one in three adolescents and teens has prediabetes. Between the periods 1999-2002 and 2015-2018, the rate increased more than twice, from 12% to 28%, among 12- to 19-year-olds. 

Furthermore, 1 in 20 seniors age 65 and older develop diabetes, about 2.3 years after being diagnosed with prediabetes.

Prediabetes is a condition in which a person’s hemoglobin A1c (HbA1c) level is equal to or greater than 5.7% but lower than 6.5%. For context, a normal HbA1C is below 5.7%. An individual is diagnosed with diabetes if their average blood sugar level is equal to or greater than 6.5%. 

Unlike type 2 diabetes, which is incurable, prediabetes is reversible with medications and lifestyle changes. Early intervention is key to preventing full-blown diabetes. 

Incretin mimetic drugs, such as Zepbound, have shown a reduction in the risk of diabetes progression of up to 94%, according to a recent study. Will this help reduce the number of new diabetes cases? 

Tirzepatide Cuts the Risk of Developing Diabetes by 94%

The manufacturer of Zepbound, Eli Lilly, recently released the results from the Phase 3 SURMOUNT-1 study. The SURMOUNT study is a series of clinical trials evaluating the safety and effectiveness of tirzepatide, the active substance in Zepbound (approved by the FDA for weight loss) and Mounjaro (approved by the FDA for diabetes). 

Tirzepatide belongs to a class of medications known as dual receptor agonists. It binds to and activates glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors to suppress appetite and control blood sugar levels. 

The Phase 3 study lasted a total of 193 weeks, comprising a 176-week treatment period and a 17-week off-treatment period. It involved 1,032 adults with prediabetes and obesity or overweight. Participants were randomized to receive weekly tirzepatide injections at doses of 5 mg, 10 mg, or 15 mg or placebo.

After the treatment, researchers discovered that pooled doses of tirzepatide reduced the risk of prediabetes progressing to diabetes by 94% compared to placebo, a statistically significant outcome. Only 1.3% of participants in the tirzepatide group were diagnosed with diabetes compared to 13.3% of the placebo group. Nearly 99% of participants treated with tirzepatide remained diabetes-free at 176 weeks.

Additional Health Benefits of Tirzepatide

Besides delaying or preventing the onset of type 2 diabetes, tirzepatide also demonstrated impressive weight loss outcomes. Participants treated with 5 mg, 10 mg, and 15 mg of tirzepatide lost an average of 15.4%, 19.9%, and 22.9% of their body weight, respectively. They maintained these results for more than three years post-treatment. 

Participants on tirzepatide also saw improvements in cardiometabolic risk factors, such as fasting insulin, lipid levels, and blood pressure. All of these benefits contributed to the delayed progression of type 2 diabetes. 

Zepbound for Prediabetes and Its Impact on Public Health

Prediabetes and obesity are influential risk factors for diabetes. The fact that these conditions are reversible assures health experts that emerging diabetes cases can be mitigated, reducing the significant burdens on the nation’s healthcare system. 

According to the CDC, 1.2 million new cases of diabetes were diagnosed in 2021, the recent period for which data is available. This equates to 5 new cases per 1,000 people annually — a concerning rate. It’s no surprise that diabetes has become the eighth leading cause of death in the U.S. It also causes complications that increase the yearly fatality rate among Americans.

Expanding the treatment options for obesity and prediabetes could curb the annual incidence of type 2 diabetes. Positive lifestyle shifts, such as regular exercise and a balanced diet, remain the first line of defense, but they have limitations and may not be effective for everyone. For people who struggle to bring their blood sugar down using natural approaches, GLP-1 medications like tirzepatide represent promising new interventions for those who don’t respond to lifestyle changes alone.

Tirzepatide can be considered a supplementary therapy for prediabetes and obesity, especially in high-risk individuals with metabolic disorders or genetically predisposed to diabetes. Using these medications — under a healthcare provider’s supervision — could reduce the diagnosed cases of diabetes and lower long-term healthcare costs. 

The FDA hasn’t approved Zepbound for prediabetes yet. However, if the agency does so in the future, people can take prediabetic shots to delay the onset or reverse impaired glucose control functions. This change could shift the trajectory of the diabetes epidemic not only in the U.S. but around the world, helping millions lead healthier and longer lives. 

Tirzepatide for Obesity Treatment and Diabetes Prevention

Tirzepatide is the active ingredient in two brand-name medications manufactured by Eli Lilly — Zepbound and Mounjaro. Zepbound is approved for the treatment of obesity or overweight with weight-related comorbidity. On the other hand, Mounjaro is medically cleared for treating type 2 diabetes together with diet and exercise. Both are prescription-only medications administered via a subcutaneous injection every week.

FDA-monitored clinical trials have demonstrated the efficacy of tirzepatide in regulating blood sugar levels and promoting weight loss. The recent announcement from Eli Lilly has opened up a possibility for tirzepatide’s third official use. At the moment, some healthcare providers are already prescribing tirzepatide for off-label purposes, such as for depression, obsessive-compulsive disorder, and other mental health problems. Until Zepbound is officially approved for prediabetes, patients may turn to non-drug strategies, such as diet and exercise, to normalize their blood sugar levels.

Side Effects of Using Zepbound for Prediabetes

Zepbound has already seen off-label use beyond its approved indication. Now that the study has proved it works for prediabetes, some healthcare providers may include prediabetes among its off-label uses and prescribe it accordingly.

The downside of using it off-label is the unexpected side effects. Zepbound, as a dual agonist, can cause minor and severe side effects. At least 5% of users reported experiencing nausea, diarrhea, fatigue, hair loss, and gastroesophageal reflux disease. In rare cases, Zepbound may cause acute kidney injury, severe inflammation of the pancreas, and acute gallbladder disease. 

These side effects are expected based on the results of clinical trials. If your doctor recommends Zepbound for off-label prediabetes, you may develop new symptoms. If this is the case, ensure you take the medication under your doctor’s supervision for close monitoring of any adverse reactions.

Zepbound Helps Treat Prediabetes

Diabetes and its complications rank high among the leading causes of death in the U.S. Tirzepatide and other incretin-based therapies may be the key to reducing the incidence rate of type 2 diabetes and fatalities associated with it. Recent findings suggest Zepbound may be one of the most promising treatments, especially for high-risk individuals due to genetic factors or metabolic conditions. Currently, people can only hope that future studies with similar outcomes will lead to the FDA approving Zepbound for the treatment of prediabetes.  

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