Diabetes affects around 1 in 5 people in the UK. Living with diabetes can be tough, and finding the right treatment can help you manage your blood sugar levels effectively. 

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Two of the most talked-about medications in recent years are tirzepatide and semaglutide. Both belong to a class of injectable drugs that improve blood sugar control while also helping with weight loss, but they are not identical.

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So, what are the differences between the two, and how do they compare in managing diabetes? Let’s find out. 

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In this article, we’ll compare tirzepatide vs semaglutide for diabetes, including how they work, their approved uses, side effects, and which may be more effective.

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Key Takeaways

• Tirzepatide and semaglutide are both injectable medications used to treat type 2 diabetes.
• Tirzepatide works on two hormone receptors(GLP-1 and GIP), while semaglutide works on one receptor (GLP-1 only).
• Side effects are similar, including nausea, vomiting, and diarrhoea, though severity can vary by patient.

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What is Tirzepatide?

Tirzepatide is a highly effective weight loss and type 2 diabetes treatment, sold under the brand name Mounjaro. It is a once-weekly injection that mimics two naturally occurring hormones:

• GLP-1 (glucagon-like peptide-1)
• GIP (glucose-dependent insulinotropic polypeptide)

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This makes it a first-in-class GIP and GLP-1 receptor agonist. It targets both pathways, which helps to enhance insulin release, reduce appetite, and improve overall blood sugar regulation.

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Approved Uses for Mounjaro

1. Type 2 diabetes treatment (FDA and MHRA approved)
2. Obesity management (approved for use in the NHS for a specific cohort of patients, but not yet universally available for this use  due to NHS resource limitations)

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What is Semaglutide?

Semaglutide is another once-weekly injection treatment. You may be familiar with the brand names Ozempic and Wegovy – both of which contain the active ingredient semaglutide. 

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Semaglutide only mimics the GLP-1 hormone, whereas tirzepatide mimics both GLP-1 and GIP. Despite this, semaglutide is still highly effective. As it replicates the GLP-1 hormone, it helps to regulate blood sugar, delay gastric emptying and reduce appetite – making it easier to maintain a healthy diet and avoid overeating. 

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Approved Uses for Wegovy and Ozempic

1. Type 2 diabetes treatment (Ozempic)
2. Obesity and weight management (Wegovy)
3. Cardiovascular risk reduction in adults with type 2 diabetes and/or established heart disease with a 20% reduction in risk of heart attacks, strokes and death due to cardiovascular disease. An effect which is independent of the individual's weight.  

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Tirzepatide vs Semaglutide Comparison

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Which is Most Effective?

For Diabetes

Clinical studies suggest that tirzepatide may reduce HbA1c levels more effectively than semaglutide, thanks to its dual mechanism. A Frontiers systematic review of the Effectiveness of Semaglutide versus Liraglutide, Dulaglutide or Tirzepatide found that tirzepatide lowers HbA1c by about 2% to 2.5%, while semaglutide lowers it by approximately 1% to 2%.

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So, tirzepatide appears to be more effective for diabetes management than semaglutide, but both drugs are highly effective for managing blood sugar in type 2 diabetes. 

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The only point to note is that in the diabetes trials, the Semaglutide is often not taken up to the higher doses used for weight loss, so there is room for interpretation.

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For Weight Loss

Tirzepatide is also currently the clear winner when it comes to weight loss too. In the SURMOUNT-1 clinical trial, patients lost up to 22.5% of their body weight on Mounjaro. 

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On Wegovy (semaglutide), however, patients have been shown to lose between 17 -20 %  of their body weight in some of the STEP and STEP UP trials with the upcoming Semaglutide dose of 7.2 mg/ week.   

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Both medications support weight loss, but head-to-head trials have shown tirzepatide leading to greater average weight reductions than the currently highest dose of semaglutide 2.4 mg weekly.

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Learn more – can diabetes medication help with weight loss?

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Tirzepatide vs Semaglutide Side Effects

Although they contain different active ingredients, both treatments can lead to similar side effects. Some of the more common side effects include:

• Nausea
• Vomiting
• Diarrhoea
• Reduced appetite

Some patients may also experience constipation, abdominal pain, or fatigue. Please note that these are usually mild and should subside as your body adjusts to your dose. 

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• More on Wegovy side effects
• More on weight loss medication side effects

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How to Take Tirzepatide and Semaglutide for Diabetes

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• Both are once-weekly injections, usually administered in the abdomen, thigh, or upper arm.
• Doses start low and gradually increase to reduce side effects.
• Neither medication should be used without a prescription, and suitability depends on your health history.

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Which Should I Choose? 

Tirzepatide and semaglutide both offer strong benefits in managing blood sugar and supporting weight loss – but tirzepatide may provide greater reductions in HbA1c and weight depending on dose. 

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The best choice depends on your personal health needs, treatment goals, and advice from a healthcare professional.

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A key determinant is also price, so that is worth weighing up for the amount of efficacy – and it is common for people to start with one and swap to another if they need to.

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It is also important to recognise that at this time the proven benefit for heart attack, stroke and death reduction sits with Wegovy.

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Book a consultation with our team of weight loss specialists today to determine the best approach for you. 

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We offer both Mounjaro prescriptions and Wegovy prescriptions here at Dr Frank’s Weight Loss Clinic, and can provide you all the support you need to manage your type 2 diabetes effectively and/ or reach your goal weight. 

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Start your assessment today. 

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