Eficacia de la Tirzepatida versus Semaglutida en el control glucémico de pacientes adultos con diabetes mellitus tipo 2: revisión sistemática

Abstract

Introduction: Type 2 diabetes mellitus is a disease characterized by hyperglycemia resulting from insulin resistance due to a progressive loss of pancreatic beta-cell function. Recently, dual glucagon-like peptide-1 agonists and glucose-dependent insulinotropic polypeptide receptor agonists have been approved as part of pharmacological treatment, specifically tirzepatide and semaglutide. Objective: To determine the efficacy of tirzepatide versus semaglutide in glycemic control in adult patients with type 2 diabetes mellitus. Methods: A systematic review with a descriptive, retrospective, and qualitative approach. The review will be conducted using the PRISMA 2020 guidelines. Results: Tirzepatide achieved HbA1c levels of up to ≤ 5.7%, while semaglutide reached HbA1c levels of ≤ 6.5%. Both therapies resulted in weight loss, with tirzepatide showing a greater reduction in weight, reaching up to -14.8 kg, compared to semaglutide, which achieved a reduction of up to -8 kg. The adverse effects associated with the medications were mild and transient, primarily gastrointestinal in nature, with the most common being nausea, vomiting, diarrhea, constipation, and reduced appetite. Cases of hypoglycemia were rarely reported and resolved without clinical complications. In the reported cases, the onset of diabetic retinopathy was associated with a prolonged duration of poorly controlled type 2 diabetes mellitus. Conclusions: Tirzepatide demonstrated greater efficacy in controlling HbA1c, with averages of ≤ 5.7%, and a greater reduction in body weight with minimal adverse events. Keywords: Tirzepatide, gastric inhibitory polypeptide, glucagon-like peptide receptor agonists, type 2 diabetes mellitus, incretins