Tirzepatide Shows Expanded Benefits Beyond Diabetes in Recent Studies

Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 receptor agonist (GLP-1 RA), demonstrated significant benefits beyond diabetes management in recent clinical studies, including reduced glaucoma risk and improved outcomes in pediatric populations.

A retrospective clinical cohort study published in the American Journal of Ophthalmology evaluated the association between tirzepatide initiation and the risk of primary open-angle glaucoma (POAG), ocular hypertension (OHT), and glaucoma treatment initiation in patients with type 2 diabetes mellitus (T2DM). Investigators identified T2DM patients using tirzepatide using the U.S. Collaborative Network within the TriNetX platform, which included 71 U.S. healthcare organizations, from June 2022 to May 2025.

The researchers identified 41,850 individuals who initiated tirzepatide and 147,828 patients who initiated selective GLP-1 RAs. After propensity score matching (1:1), 41,849 patients remained in each cohort. Compared to the selective GLP-1 RA users, the tirzepatide group was younger (mean age 55.1 years vs. 56.6 years), had a higher proportion of white patients (70.5% vs. 63.8%), lower rates of chronic kidney disease (10.3% vs. 13.5%), decreased insulin use (29.9% vs. 35.4%), higher body mass index (38.1 kg/m2 vs. 36.8 kg/m2), and lower hemoglobin A1c (7.3 vs 7.6).

Compared to selective GLP-1 RAs, tirzepatide use was associated with a significantly lower risk of POAG (risk ratio: 0.50, 95% confidence interval: 0.34-0.74), OHT (risk ratio: 0.59, 95% confidence interval: 0.40-0.88), and need for glaucoma treatment (risk ratio: 0.54, 95% confidence interval: 0.45-0.64). These risk reductions persisted in subgroups with concomitant metformin or insulin use. Sensitivity analyses limited to patients aged 60 years and older and comparison with individual GLP-1 RAs, including semaglutide and dulaglutide, yielded consistent results.

In pediatric populations, an analysis of phase III clinical trial data published in The Lancet found that tirzepatide significantly improved glycemic control and BMI compared with placebo in adolescents with Type 2 diabetes. The study is the first to show a GLP-1 medication enabling weight loss in adolescents with Type 2 diabetes. Tirzepatide is now the most powerful therapy within this class of medications for this condition, both in terms of weight loss and glucose lowering effect.

One of the medication's key differences is that it's a dual agonist for both glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptors. When administered together, they appear to act synergistically toward both A1C reduction and weight loss. While other GLP-1 medications studied in adolescents have lowered A1C by about one percentage point, weight loss has been marginal. Unlike several other GLP-1s, even the starting dose of tirzepatide (including 2.5 mg) improved blood glucose levels in clinical trials done in adults (SURPASS-1 and SURPASS-2).

A retrospective study led by Children's Hospital Los Angeles reviewed about two years of clinical data to compare adolescents on metformin only to those on a GLP-1 only. Patients on a standalone GLP-1 achieved similar improvement in HbA1c, but a greater reduction in their BMI, compared to those on metformin.

Tirzepatide has been added to the World Anti-Doping Agency's 2026 monitoring programme. The programme, effective since January 1, 2026 and currently rolled out at the Winter Olympic Games, states that markers of both semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro, Zepbound) will be tracked in and out-of-competition to detect patterns of misuse. Semaglutides were introduced to the World Anti-Doping Agency's monitoring programme in 2024 but are not currently prohibited.

GLP-1 RAs are used to treat type 2 diabetes but some athletes might seek them out to induce rapid weight loss and alter body composition. Potential adverse health effects for elite athletes using GLP-1 RAs include decreased energy intake, impaired recovery, and reduced muscle performance. A 2025 qualitative analysis examined approximately 12,400 social media posts across two bodybuilding platforms concerning GLP-1RA use trends, polypharmacy, and side effect management. The study found dangers surrounding GLP-1RA use in sport settings including experimental dosing, cycling or stacking different GLP-1RAs, and combining anabolic androgenic steroids with GLP-1RAs to avoid muscle waste.

Trials of GLP-1-based therapies including tirzepatide and semaglutide have reported an expected weight loss of 15%-22% and show improvements in sleep apnea, fatty liver, and cardiovascular disease. Tirzepatide has shown superior efficacy in glycemic control, weight loss, and cardiometabolic outcomes compared to GLP-1 RAs alone.