Tirzepatide Vs. Traditional Treatments: What’s the Difference?

Oral medications – including metformin, sulfonylureas, and DPP-4 inhibitors – are commonly prescribed for diabetes management. These medications support various functions: some help the body process insulin more effectively, others stimulate insulin production, and some slow down the digestion of carbohydrates to limit spikes in blood sugar levels.

Tirzepatide belongs to a newer class of medicines referred to as dual GIP and GLP-1 receptor agonists.² This medication functions by mirroring the action of two hormones that stimulate insulin release from the pancreas, suppress glucagon secretion (a hormone that raises blood sugar), and delay stomach emptying to reduce post-meal blood sugar spikes.

Oral medications are taken in pill form, typically once or twice daily with meals, while tirzepatide is administered via injection once per week. Many oral medications may lead to weight gain or have neutral effects on weight, whereas tirzepatide promotes weight loss in addition to improving blood sugar control.

In terms of side effects, both tirzepatide and oral medications can cause gastrointestinal symptoms such as nausea, vomiting, or diarrhea, although these effects may vary in severity and frequency among individuals.³

Individuals who struggle with weight management or are looking for additional benefits beyond blood sugar control may find tirzepatide to be the preferred choice. Clinical studies have shown that tirzepatide not only lowers blood sugar levels but also aids in weight loss, making it a desirable option for patients who are overweight or obese.⁴

Patients with a history of gastrointestinal issues or intolerance to oral medications may find tirzepatide more sustainable, as the most common side effects are related to the gastrointestinal system and may be less pronounced with the injectable form of medication.

For patients with concerns about hypoglycemia (low blood sugar), certain oral medications, such as sulfonylureas, may carry a higher risk when compared to tirzepatide. Tirzepatide presents a lower risk of hypoglycemia because it stimulates insulin release in a glucose-dependent manner, meaning insulin is only released when blood sugar levels are elevated.

Finally, cost considerations may also play a significant role in treatment decisions. While oral medications are typically less expensive than injectable medications like tirzepatide, insurance coverage and copay assistance programs may help offset the cost for some patients.

Tirzepatide functions by stimulating insulin release from the pancreas, suppressing glucagon secretion (a hormone that raises blood sugar), and delaying stomach emptying to reduce post-meal blood sugar spikes.

Insulin therapy involves injecting insulin through multiple regular injections or an insulin pump. Insulin therapy directly replaces the insulin that the body is unable to produce or use effectively, therefore lowering blood sugar levels.

Tirzepatide promotes weight loss in addition to improving glycemic control, which may be particularly advantageous for overweight or obese patients with diabetes.

Both tirzepatide and insulin therapy have been shown to lower blood sugar levels in patients associated with type 2 diabetes.⁵

Hypoglycemia, or low blood sugar, is a concern for patients on insulin therapy, especially if dosages are not carefully adjusted or if meals are missed or delayed.

Previously, the belief was that tirzepatide offered a lower risk of hypoglycemia compared to some forms of insulin therapy, particularly basal insulins. However, newer basal insulins, including glargine (300 units/mL) and degludec (100 and 200 units mL), possess pharmacokinetic properties. These specific insulins exhibit sustained half-lives and decidedly level glucose control profiles, which can lessen the symptoms of hypoglycemia.

For some individuals, the idea of injecting insulin multiple times a day may be daunting or inconvenient. In contrast, tirzepatide is administered once a week.

The potential for long-term weight loss with tirzepatide may be a motivating factor for patients who are struggling with obesity or weight management. Insulin therapy, particularly certain formulations like basal insulins, is known to cause weight gain in some people, which may be undesirable for patients who are already dealing with weight-related issues.⁶