Switching to tirzepatide from dulaglutide improved HbA1c and weight across baseline characteristics
Last updated May 30, 2026
Key finding
Switching to tirzepatide from dulaglutide resulted in consistently greater HbA1c and weight reductions versus dulaglutide dose escalation across all baseline subgroups in adults with T2D.
This subgroup analysis of SURPASS-SWITCH found that switching to tirzepatide from dulaglutide provided greater improvements in blood sugar control and weight loss compared to escalating dulaglutide dose, with consistent benefits across all patient groups including different ages, baseline HbA1c levels, diabetes duration, BMI categories, and ethnicities.
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Study at a glance
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EvidenceScore™
High
Study type
Randomized Controlled Trials (RCTs)
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
Switching to tirzepatide from dulaglutide resulted in consistently greater HbA1c and weight reductions versus dulaglutide dose escalation across all baseline subgroups in adults with T2D.
Published in
Journal Reference
Publication details and source links for this paper.
Violante-Ortiz R, Rose L, Sharma P, et al. Safety and efficacy of switching from dulaglutide to tirzepatide across clinically relevant baseline characteristics in participants with T2D: subgroup analysis of SURPASS-SWITCH. BMJ Open Diabetes Res Care. 2026;14(2):e005711. doi:10.1136/bmjdrc-2025-005711
Main Effects
HbA1c ↓ greater with tirzepatide vs dulaglutide across all subgroups (difference -0.7% to -1.2%)
Body weight ↓ greater with tirzepatide vs dulaglutide across all subgroups (difference -5.7 to -8.6 kg)
Adverse events rates similar between treatments, with GI symptoms (nausea, diarrhea) most common
Evidence Suggest
- Tirzepatide switching provided consistent HbA1c and weight reductions regardless of age, sex, ethnicity, diabetes duration, BMI, baseline HbA1c, or dulaglutide dose/duration
- HbA1c reductions were numerically larger in participants with higher baseline HbA1c (>8.5%) and lower BMI (<27 kg/m²)
- Weight reduction was significantly greater in non-Hispanic/Latino participants compared to Hispanic/Latino participants
Who this applies to
Adults with type 2 diabetes on dulaglutide 0.75mg or 1.5mg with HbA1c 7.0-9.5%
Keep in Mind
Results represent a subgroup analysis; interpret with caution given multiple comparisons
Between the Lines
- Open-label study design may introduce bias
- Limited sample sizes in some subgroups (e.g., BMI <27 kg/m²: n=27)
- Study not powered for subgroup analyses or safety comparisons
- Multiple subgroup testing increases risk of false-positive findings
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