Real-World Effectiveness of Insulin Glargine 300 U/ml in People with Type 2 Diabetes Previously Treated with Tirzepatide: The DELIVER-T Study.

Diabetes therapy : research, treatment and education of diabetes and related disorders2026PMID: 41269514

View on PubMed DOI: 10.1007/s13300-025-01798-5

Plain Language Summary

DELIVER-T retrospective study (Optum US claims, January 2022–August 2024) evaluating glycemic control in insulin-naive T2DM patients suboptimally controlled on tirzepatide who were intensified with insulin glargine 300 U/ml (Gla-300). Characterizes the real-world treatment pathway when tirzepatide alone is insufficient for glycemic targets. Provides the first real-world evidence on insulin intensification after tirzepatide failure—informing clinicians on expected HbA1c response when transitioning tirzepatide-treated patients to basal insulin, a common clinical scenario given tirzepatide's growing use as a first-line injectable.

Abstract

INTRODUCTION: Tirzepatide is recommended as a first-line injectable for people with type 2 diabetes (T2D), but there is a paucity of data on the use of basal insulin after tirzepatide in this population. This study aimed to evaluate glycemic control in people with T2D newly intensified with insulin glargine 300 U/ml (Gla-300) who had suboptimal HbA1c after treatment with tirzepatide. METHODS: DELIVER-T was a retrospective analysis of the US Optum's ClinformaticsData Mart from January 1, 2022 to August 31, 2024. People with T2D were included if they were insulin naïve and were previously treated with tirzepatide and then intensified with Gla-300. The primary analysis (Gla-300 switch/add-on group) included all those with a HbA1c > 7.0% at baseline who either switched from tirzepatide to Gla-300 or who added Gla-300 to tirzepatide. The primary endpoint was the change in HbA1c levels from baseline to 6 months. Secondary endpoints included reaching HbA1c target < 7.0% and any hypoglycemia. RESULTS: In total, 82 people had a HbA1c > 7.0% at baseline and were included in the primary analysis (Gla-300 switch/add-on group). The mean (SD) change in HbA1c from baseline to 6 months was - 1.3% (2.0; p = 0.0027) for the primary analysis (Gla-300 switch/add-on group). The proportion of participants reaching the target of HbA1c < 7.0% at 6 months was 26.8% (n = 22) for the primary analysis (Gla-300 switch/add-on group). No hypoglycemic events were captured in the database during the 6-month follow-up period. CONCLUSIONS: In insulin-naïve people with T2D who had suboptimal HbA1c with tirzepatide, significant reductions in HbA1c and improvements in the percentage of people reaching HbA1c target of < 7.0% were observed with Gla-300. Infographic and video abstract available for this article. Please follow the digital features link under the abstract. A video abstract of the Deliver-T study, which evaluated glycaemic control in people with T2D previously treated with tirzepatide and newly intensified with insulin glargine 300 U/mL (Gla-300).

Authors

Ritzel, Robert; Davies, Melanie J; Hao, Lichen; Ji, Linong; Mk, Lintu; Mabunay, Aileen; Mauricio, Didac; Bailey, Timothy

Keywords

Basal insulinGIPGLP-1 RAInsulin glargine 300 U/mlReal-world evidenceTirzepatideType 2 diabetes