Semaglutide and tirzepatide are two of the most effective newer pharmacological treatments for T2D and obesity. Semaglutide is a GLP-1 receptor agonist, while tirzepatide has a dual mechanism, acting on both GLP-1 and GIP receptors, enhancing its effects on glycaemic control and weight loss. Both medications improve blood glucose by stimulating insulin secretion, suppressing glucagon release, slowing gastric emptying and increasing satiety, thereby reducing overall calorie intake. Clinical trials have demonstrated significant reductions in HbA1c and body weight, along with cardiovascular benefits. However, adverse effects have been reported, with the most common being gastrointestinal, such as nausea, vomiting, diarrhoea and constipation.

  1. O’Keefe JH, Franco WG, O’Keefe EL. Anti-consumption agents: Tirzepatide and semaglutide for treating obesity-related diseases and addictions and improving life expectancy. Prog Cardiovasc Dis. 2025 Mar-Apr;89:102-112. doi: 10.1016/j.pcad.2024.12.010. Epub 2024 Dec 30. PMID: 39743126; PMCID: PMC12103286
  2. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an East Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial
  3. Cui, Yuying et al. Comparative efficacy and safety of tirzepatide in Asians and non-Asians with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Therapy 15.4 (2024): 781-799
  4. McGowan B, Ciudin A, Baker JL et al. A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults. Nat Med 31, 3317–3329 (2025). https://doi.org/10.1038/s41591-025-03978-z
  5. Gao L, Lee BW, Chawla M, Kim J, Huo L, Du L, Huang Y, Ji L. Tirzepatide versus insulin glargine as second-line or third-line therapy in type 2 diabetes in the Asia-Pacific region: the SURPASS-AP-Combo trial. Nat Med. 2023 Jun;29(6):1500-1510. doi: 10.1038/s41591-023-02344-1. Epub 2023 May 25. PMID: 37231074
  6. Rosenstock J, Frías JP, Rodbard HW, Tofé S, Sears E, Huh R, Fernández Landó L, Patel H. Tirzepatide vs Insulin Lispro Added to Basal Insulin in Type 2 Diabetes: The SURPASS-6 Randomised Clinical Trial. JAMA. 2023 Nov 7;330(17):1631-1640. doi: 10.1001/jama.2023.20294. Erratum in: JAMA. 2023 Nov 21;330(19):1915. doi: 10.1001/jama.2023.22757. Erratum in: JAMA. 2025 Apr 22;333(16):1460. doi: 10.1001/jama.2025.3806. PMID: 37786396; PMCID: PMC10548360
  7. Joseph JJ, Ortiz R, Acharya T, Golden SH, López L, Deedwania P. Cardiovascular impact of race and ethnicity in patients with diabetes and obesity. https://doi.org/10.1016/j.jacc.2021.06.020. J Am Coll Cardiol. 2021;78:2471–2482. doi: 10.1016/j.jacc.2021.06.020. [DOI] [PubMed] [Google Scholar
  8. Iftikhar P, Khatri CP, Nanduri SRD, Ramzan M, Sakalabaktula KSK. Assessing the Safety of Semaglutide and Tirzepatide in Black and Asian Populations: A Narrative Review. Cureus. 2025 Jul 2;17(7):e87188. doi: 10.7759/cureus.87188. PMID: 40755607; PMCID: PMC12316492

About the Author: Fareeha Jay, RD

Fareeha is a Freelance Dietitian providing specialist advice to South Asians across the globe and has developed the South Asian Eatwell Guide.

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Semaglutide and tirzepatide are two of the most effective newer pharmacological treatments for T2D and obesity. Semaglutide is a GLP-1 receptor agonist, while tirzepatide has a dual mechanism, acting on both GLP-1 and GIP receptors, enhancing its effects on glycaemic control and weight loss. Both medications improve blood glucose by stimulating insulin secretion, suppressing glucagon release, slowing gastric emptying and increasing satiety, thereby reducing overall calorie intake. Clinical trials have demonstrated significant reductions in HbA1c and body weight, along with cardiovascular benefits. However, adverse effects have been reported, with the most common being gastrointestinal, such as nausea, vomiting, diarrhoea and constipation.

  1. O’Keefe JH, Franco WG, O’Keefe EL. Anti-consumption agents: Tirzepatide and semaglutide for treating obesity-related diseases and addictions and improving life expectancy. Prog Cardiovasc Dis. 2025 Mar-Apr;89:102-112. doi: 10.1016/j.pcad.2024.12.010. Epub 2024 Dec 30. PMID: 39743126; PMCID: PMC12103286
  2. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an East Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial
  3. Cui, Yuying et al. Comparative efficacy and safety of tirzepatide in Asians and non-Asians with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Therapy 15.4 (2024): 781-799
  4. McGowan B, Ciudin A, Baker JL et al. A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults. Nat Med 31, 3317–3329 (2025). https://doi.org/10.1038/s41591-025-03978-z
  5. Gao L, Lee BW, Chawla M, Kim J, Huo L, Du L, Huang Y, Ji L. Tirzepatide versus insulin glargine as second-line or third-line therapy in type 2 diabetes in the Asia-Pacific region: the SURPASS-AP-Combo trial. Nat Med. 2023 Jun;29(6):1500-1510. doi: 10.1038/s41591-023-02344-1. Epub 2023 May 25. PMID: 37231074
  6. Rosenstock J, Frías JP, Rodbard HW, Tofé S, Sears E, Huh R, Fernández Landó L, Patel H. Tirzepatide vs Insulin Lispro Added to Basal Insulin in Type 2 Diabetes: The SURPASS-6 Randomised Clinical Trial. JAMA. 2023 Nov 7;330(17):1631-1640. doi: 10.1001/jama.2023.20294. Erratum in: JAMA. 2023 Nov 21;330(19):1915. doi: 10.1001/jama.2023.22757. Erratum in: JAMA. 2025 Apr 22;333(16):1460. doi: 10.1001/jama.2025.3806. PMID: 37786396; PMCID: PMC10548360
  7. Joseph JJ, Ortiz R, Acharya T, Golden SH, López L, Deedwania P. Cardiovascular impact of race and ethnicity in patients with diabetes and obesity. https://doi.org/10.1016/j.jacc.2021.06.020. J Am Coll Cardiol. 2021;78:2471–2482. doi: 10.1016/j.jacc.2021.06.020. [DOI] [PubMed] [Google Scholar
  8. Iftikhar P, Khatri CP, Nanduri SRD, Ramzan M, Sakalabaktula KSK. Assessing the Safety of Semaglutide and Tirzepatide in Black and Asian Populations: A Narrative Review. Cureus. 2025 Jul 2;17(7):e87188. doi: 10.7759/cureus.87188. PMID: 40755607; PMCID: PMC12316492

About the Author: Fareeha Jay, RD

Fareeha is a Freelance Dietitian providing specialist advice to South Asians across the globe and has developed the South Asian Eatwell Guide.

Leave A Comment

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