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A second, more recent analysis (Lee and Kim, DMRR 2026) found no significant signal for tirzepatide once it had been statistically adjusted
It depends on the individual case
Ozempic is approved for type 2 diabetes glycemic control (2017), cardiovascular risk reduction in T2D (2020), and CKD progression in T2D (February 2026)
Combining with DPP-4 inhibitors is generally not recommended, as both drug classes work on the incretin system Adding basal insulin for those with more significant hyperglycaemia, which can be used alongside GLP-1 medications (with careful monitoring for hypoglycaemia) Switching to insulin therapy entirely may be necessary for those with advanced beta cell failure For weight management , when GLP-1 medications don't produce adequate weight loss, alternatives include: Orlistat , a lipase inhibitor that reduces fat absorption, though weight loss is typically modest (2-3 kg on average) Naltrexone-bupropion (Mysimba), which works on appetite centres through different pathways
A 2023 systematic review and meta-analysis published in the Journal of Clinical Medicine found that semaglutide reduced systolic blood pressure by approximately 5 mmHg and diastolic blood pressure by about 2.5 mmHg in patients without diabetes
This is the moment when a conversation with a bariatric surgeon often becomes the most practical next step
