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SURPASS-PEDS clinical infographic

Tirzepatide significantly improved HbA1c and BMI in youth-onset type 2 diabetes over 30 weeks

Source
Source: Hannon et al. reported the SURPASS-PEDS phase 3 randomized, double-blind, placebo-controlled trial of tirzepatide in children and adolescents with type 2 diabetes in The Lancet (2025).

Effects were sustained to 1 year, positioning tirzepatide as a potential new evidence-based option for adolescents with inadequately controlled type 2 diabetes.

Why it matters

Youth-onset type 2 diabetes has limited treatment options and is often harder to control than adult-onset disease, with early need for durable glycaemic control and cardiometabolic risk reduction.

Clinical question
Can tirzepatide improve HbA1c and BMI in adolescents with inadequately controlled type 2 diabetes?
Study at a glance
Design
Phase 3, randomized, double-blind, placebo-controlled
Population
99 participants aged 10 to <18 years
Sites
39 sites across 8 countries
Arms
Tirzepatide 5 mg, tirzepatide 10 mg, or placebo
Primary window
Week 30 efficacy comparison
Durability
Effects sustained to 1 year
Central finding: HbA1c at week 30
Pooled tirzepatide
−2.23 pp HbA1c change from baseline at 30 weeks
Placebo
+0.05 pp HbA1c change from baseline at 30 weeks
−2.28% Estimated treatment difference vs placebo
95% CI −2.87 to −1.69 Confidence interval for HbA1c treatment difference
p<0.0001 Statistical significance at week 30
Forest-style estimate: HbA1c treatment difference vs placebo
BMI efficacy: dose-response pattern
Key efficacy numbers
HbA1c
Pooled tirzepatide reduced HbA1c by −2.23 percentage points vs a +0.05-point increase with placebo.
p<0.0001
BMI, 5 mg
BMI decreased by −7.4% at week 30 with tirzepatide 5 mg.
vs −0.4% placebo
BMI, 10 mg
BMI decreased by −11.2% at week 30 with tirzepatide 10 mg.
vs −0.4% placebo
Numbers to know
99 Randomized participants with youth-onset type 2 diabetes
10 to <18 Age range, years
8.04% Mean baseline HbA1c
−0.4% BMI change with placebo at week 30
−7.4% BMI change with tirzepatide 5 mg at week 30
−11.2% BMI change with tirzepatide 10 mg at week 30
Safety profile
Adverse events
Most adverse events were gastrointestinal, consistent with the adult tirzepatide experience.
Severity and timing
Gastrointestinal events were generally mild to moderate and decreased over time.
Mortality
0 Deaths reported
Discontinuations
Monitor tolerability Discontinuation counts were not specified in the supplied brief; GI symptoms remain the key practical monitoring point.
Takeaway

A new evidence-based option may be emerging for adolescents with inadequately controlled type 2 diabetes, combining strong glycaemic and weight-related efficacy with the need for careful gastrointestinal monitoring and longer-term pediatric safety data.

AbbreviationsQuick
Abbreviations: BMI, body mass index; CI, confidence interval; GLP-1, glucagon-like peptide-1; HbA1c, glycated haemoglobin.
Bibliography1
  1. Hannon TS, Chao LC, Barrientos-Pérez M, Pamidipati KC, Landó LF, Lee CJ, et al. 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)