Tirzepatide for adolescents with type 2 diabetes: glycaemic control and BMI over 30 weeks

Source

Source: Lancet phase 3 trial publication on tirzepatide in children and adolescents with type 2 diabetes, identified as SURPASS-PEDS. The study compared tirzepatide with placebo over a 30-week double-blind period followed by an open-label extension.

Tirzepatide markedly improved blood sugar control and reduced BMI in adolescents with type 2 diabetes over 30 weeks, with benefits sustained to 1 year.

Why this matters

Youth-onset type 2 diabetes is difficult to treat, and current options often deliver weaker glycaemic control than in adults. A treatment that improves both HbA1c and BMI could meaningfully change specialist paediatric diabetes care.

Trial snapshot: SURPASS-PEDS

Design

Randomised, double-blind, placebo-controlled phase 3 trial

Population

Participants aged 10 to <18 years with type 2 diabetes

Background therapy

Inadequately controlled on metformin and/or basal insulin

Arms

Tirzepatide 5 mg, tirzepatide 10 mg, or placebo

Primary endpoint

Week 30; benefits reported as sustained to 1 year

Hero fact

HbA1c at week 30

−2.23 pp HbA1c change with tirzepatide

−2.28% Estimated treatment difference

+0.05 pp HbA1c change with placebo

Participants

99 participants randomised to tirzepatide 5 mg, tirzepatide 10 mg, or placebo

Mean age 14.7 y Baseline HbA1c 8.04%

Glycaemic efficacy

−2.28% estimated treatment difference in HbA1c at week 30 p<0.0001

BMI response

−11.2% BMI change with tirzepatide 10 mg at week 30

5 mg: −7.4% | Placebo: −0.4%

Efficacy results: BMI reduction by treatment arm

Dose-level signal

−7.4% BMI decrease with tirzepatide 5 mg

−11.2% BMI decrease with tirzepatide 10 mg

−0.4% BMI decrease with placebo

Numbers to know

−2.23 pp HbA1c change with tirzepatide at week 30

+0.05 pp HbA1c change with placebo at week 30

−2.28% estimated treatment difference; p<0.0001

8.04% mean baseline HbA1c among randomised participants

Safety profile

Common adverse events

Mostly gastrointestinal events

Pattern over time

Generally mild to moderate and decreasing over time

Mortality

No deaths reported

Tirzepatide appears to be a strong emerging treatment option for youth-onset type 2 diabetes, improving both glycaemic control and BMI; treatment decisions should be individualised with specialist paediatric diabetes care.

AbbreviationsQuick

Abbreviations: SURPASS-PEDS; HbA1c = glycated haemoglobin; GLP-1; BMI; CI; DOI; PMID.

Bibliography1

Hannon TS, Chao LC, Barrientos-Pérez M, Pamidipati KC, Landó LF, Lee CJ, Patel H, Bergman BK. Efficacy and safety of tirzepatide in children and adolescents with type 2 diabetes (SURPASS-PEDS): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2025 Oct 4;406(10511):1484-1496. (DOI: 10.1016/S0140-6736(25)01774-X)