What are the effects of Mounjaro® (tirzepatide) on postprandial blood glucose?

See important safety information, including boxed warning, in the attached prescribing information.

Postprandial Blood Glucose in Tirzepatide Type 2 Diabetes Studies

Mounjaro (tirzepatide) is a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes (T2D) for once-weekly, subcutaneous administration.¹

In the SURPASS-1 to -6 studies, changes in postprandial glucose (PPG) from baseline were assessed in adults with T2D treated with tirzepatide 5, 10, and 15 mg, placebo, semaglutide 1 mg injection, titrated insulin degludec, titrated insulin glargine, and titrated insulin lispro (Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, and Figure 6).^2-7

Figure 1. SURPASS-1: Daily Mean, Premeal Daily Mean, and 2-h Postmeal Daily Mean SMBG Change From Baseline at 40 Weeks Using mITT – Efficacy Analysis Set²

Figure 1 description: In patients receiving tirzepatide 5, 10, and 15 mg, the change from baseline in daily mean self-monitored blood glucose was -55.7, -54.3, and -55.4 mg/dL, respectively, compared to -7.6 mg/dL for placebo at week 40. The change in pre-meal daily mean was -45.3 mg/dL for tirzepatide 5 and 10 mg, and -43.6 mg/dL for tirzepatide 15 mg compared to -5.3 mg/dL for placebo. Change in 2-hour postmeal daily mean was -65.3, -61.3 and -65.0 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -10.8 mg/dL with placebo.

Abbreviations: LSM = least squares mean; mITT = modified intention-to-treat; MMRM = mixed-effects model for repeated measures; SMBG = self-monitored blood glucose.

Notes: Data are LSM (SE); MMRM analysis (40 weeks), mITT population (efficacy analysis set).

**p<.0001 vs placebo at 40 weeks, not controlled by type 1 error.

Figure 2. SURPASS-2: Daily Mean, Premeal Daily Mean, and 2-h Postmeal Daily Mean SMBG Change From Baseline at 40 Weeks Using mITT – Efficacy Analysis Set³

Figure 2 description: In patients receiving tirzepatide 5, 10, and 15 mg, the change from baseline to week 40 in daily mean self-monitored blood glucose was -65.4, -70.6, and -74.3 mg/dL, respectively, compared to -61.4 mg/dL for semaglutide 1 mg. The change in pre-meal daily mean was -57.5, -61.6, and -64.8 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -54.2 mg/dL for semaglutide 1 mg. Change in 2-hour postmeal daily mean was -71.6, -78.2, and -81.9 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -67.2 mg/dL with semaglutide 1mg.

Abbreviations: LSM = least squares mean; mITT = modified intention-to-treat; MMRM = mixed-effects model for repeated measures; SMBG = self-monitored blood glucose.

Notes: Data are LSM (SE); MMRM analysis (40 weeks).

Figure 3. SURPASS-3: Daily Mean, Premeal Daily Mean, and 2-h Postmeal Change From Baseline at 52 Weeks Using mITT – Efficacy Analysis Set⁴

Figure 3 description: In patients receiving tirzepatide 5, 10, and 15 mg, the change from baseline to week 52 in daily mean self-monitored blood glucose was -52.6, -59.7, and -60.6 mg/dL, respectively, compared to -48 mg/dL for insulin degludec. The change in pre-meal daily mean was -44.7, -51.3, and -52.3 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -46.2 mg/dL for insulin degludec. Change in 2-hour postmeal daily mean was -60.3, -67.2, and -68.2 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -50.2 mg/dL with insulin degludec.

Abbreviations: mITT = modified intention-to-treat; SMBG = self-monitored blood glucose.

Notes:  Data are estimated mean (SE).

**p<0.0001 vs insulin degludec, not controlled for type I error.

Figure 4. SURPASS-4: Daily Mean, Premeal Daily Mean, and 2-h Postmeal Daily Mean SMBG Change From Baseline at 52 Weeks Using mITT – Efficacy Analysis Set⁵

Figure 4 description: In patients receiving tirzepatide 5, 10, and 15 mg, the change from baseline to week 52 in daily mean self-monitored blood glucose was -58.4, -61.1, and -66.1 mg/dL, respectively, compared to -46.1 mg/dL for insulin glargine. The change in pre-meal daily mean was -49.6, -53.0, and -57.2 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -45.4 mg/dL for insulin glargine. Change in 2-hour postmeal daily mean was -67.4, -68.9, and -74.1 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -49.4 mg/dL with insulin glargine.

Abbreviations: mITT = modified intention-to-treat; LSM = least squares mean; SMBG = self-monitored blood glucose.

Notes: Data are LSM (SE), mITT population (efficacy analysis set).

Figure 5. SURPASS-5: Daily Mean, Premeal Daily Mean, and 2-h Postmeal Daily Mean Change From Baseline at 40 Weeks Using mITT – Efficacy Analysis Set ⁶ 

Figure 5 description: In patients receiving tirzepatide 5, 10, and 15 mg, the change from baseline to week 40 in daily mean self-monitored blood glucose was -67.1, -71.7, and -73.7 mg/dL, respectively, compared to -39.4 mg/dL for placebo. The change in pre-meal daily mean was -55.8, -58.9, and -58.1 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -36.8 mg/dL for placebo. Change in 2-hour postmeal daily mean was -76.7, -82.3, and -87.4 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -40.5 mg/dL with placebo.

Abbreviations: HbA1c = glycated hemoglobin; mITT = modified intention-to-treat; SMBG = self-monitored blood glucose.

Notes: Tested for superiority, not controlled for type 1 error. 7-point SMBG included fasting premeal, morning 2-hour postmeal, midday premeal, midday 2-hour postmeal, evening premeal, evening 2-hours postmeal, and bedtime readings. Analysis of covariance model used with treatment, country, baseline metformin use, baseline HbA1c category (≤8.0%, >8.0%) as fixed effects and baseline endpoint value as a covariate. 

Figure 6. SURPASS-6: Daily Mean, Premeal Daily Mean, and 2-h Postmeal Daily Mean SMBG Change From Baseline at 52 Weeks Using mITT – Efficacy Analysis Set⁷

Figure 6 description: In patients receiving tirzepatide 5, 10, and 15 mg, the change from baseline to week 40 in daily mean self-monitored blood glucose was -56.7, -61.5, and -67.6 mg/dL, respectively, compared to -55.8 mg/dL for insulin lispro. The change in pre-meal daily mean was -45.2, -49.4, and -53.3 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -41.5 mg/dL for insulin lispro. Change in 2-hour postmeal daily mean was -64.7, -70.6, and -78.3 mg/dL with tirzepatide 5, 10, and 15 mg respectively, compared to -65.2 mg/dL with insulin lispro.

Abbreviations: LSM = least squares mean; mITT = modified intention-to-treat; SMBG = self-monitored blood glucose.

Notes: Data are LSM (SE), mITT population (efficacy analysis set), derived from analysis of variance at baseline and a mixed-model repeated-measures analysis at week 52 (efficacy estimand).

Enclosed Prescribing Information

MOUNJARO® (tirzepatide) injection, for subcutaneous use, Lilly

References

The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).

1. Mounjaro [package insert]. Indianapolis, IN: Eli Lilly and Company; 2025.

2. Rosenstock J, Wysham C, Frías JP, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet. 2021;398(10295):143-155. https://doi.org/10.1016/S0140-6736%2821%2901324-6

3. Frías JP, Davies MJ, Rosenstock J, et al; SURPASS-2 Investigators. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. N Engl J Med. 2021;385(6):503-515. https://doi.org/10.1056/NEJMoa2107519

4. Ludvik B, Giorgino F, Jódar E, et al. Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial. Lancet. 2021;398(10300):583-598. https://doi.org/10.1016/S0140-6736(21)01443-4

5. Del Prato S, Kahn SE, Pavo I, et al; SURPASS-4 Investigators. Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. Lancet. 2021;398(10313):1811-1824. https://doi.org/10.1016/S0140-6736(21)02188-7

6. Dahl D, Onishi Y, Norwood P, et al. Effect of subcutaneous tirzepatide vs placebo added to titrated insulin glargine on glycemic control in patients with type 2 diabetes: the SURPASS-5 randomized clinical trial. JAMA. 2022;327(6):534-545. https://doi.org/10.1001/jama.2022.0078

7. Rosenstock J, Frías JP, Rodbard HW, et al. Tirzepatide vs insulin lispro added to basal insulin in type 2 diabetes: the SURPASS-6 randomized clinical trial. JAMA. 2023;330(17):1631-1640. https://doi.org/10.1001/jama.2023.20294