Active, not recruitingNCT07889453Switch TZPUpdated Oct 22, 2026

Metabolic Effects of Switching From Injectable Semaglutide to Tirzepatide

An observational study in Obesity and Type 2 Diabetes (T2D), sponsored by LMC Diabetes & Endocrinology Ltd.. Active, not recruiting at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-22.

Sponsored by LMC Diabetes & Endocrinology Ltd. · Observational

Updated Oct 22, 2026Newly registeredGo to Updates ↓

Study type: Observational
Model: Cohort
Time perspective: Retrospective
Enrollment: 650
Ages: 18 Years and older
Sex: All

Study summary

The goal of this retrospective observational study is to evaluate the effectiveness of switching from injectable semaglutide to tirzepatide in adults living with type 2 diabetes (T2D) and, descriptively, in a smaller cohort of adults living with obesity without diabetes, using clinical data from the LMC Diabetes Registry.

The study has two co-primary objectives: 1) to assess change in body weight from baseline to follow-up (6-12 months) among adults living with T2D who switched from injectable semaglutide to tirzepatide, and 2) to assess change in body weight over the same period among adults living with obesity without diabetes who switched.

Secondary objectives will compare changes in body mass index (BMI), estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (uACR), waist circumference, blood pressure, alanine transaminase (ALT), lipids, and insulin use from baseline to follow-up between adults living with T2D who switched to tirzepatide and a propensity score-matched group of adults living with T2D who continued semaglutide.

Conditions studied

Obesity
Type 2 Diabetes (T2D)

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Keywords

tirzepatide
semaglutide
type 2 diabetes
obesity
real-world evidence

In context

Obesity

6,578 studies on the registry are indexed under Obesity; 1,718 are open to participants now.

This study's planned enrollment of 650 is above the median of 132 across 1,338 observational studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

LMC Diabetes & Endocrinology Ltd. is the lead sponsor of 22 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

Who can participate

Ages eligible: 18 Years and older
Sexes eligible: All
Accepts healthy volunteers: No
Sampling method: Non-probability sample

Study population

The study populations will include adults living with T2D and adults living with obesity without diabetes, who switched from injectable semaglutide to tirzepatide, or adults living with T2D who were prescribed injectable semaglutide and did not switch to tirzepatide.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Age 18 years old or older
A clinical diagnosis of T2D ≥ 1 year
Baseline HbA1c ≥ 7.5%
≥ one HbA1c value up to 6 months (+ 90 days) prior to index date
≥ one body weight value up to 6 months (+ 90 days) prior to index date
Initiated injectable semaglutide or switched from injectable semaglutide to tirzepatide between January 1, 2022, and December 31, 2025
Use of injectable semaglutide for ≥ 3 months for both the control and switch cohort
If using real-time continuous glucose monitoring (rtCGM) or intermittently scanned continuous glucose monitoring (isCGM), CGM use for ≥ 3 months
Seen by an LMC endocrinologist in the last 18 months as of the query date
Informed data consent for their medical record data to be used for research purposes

Inclusion Criteria for Obesity (non-diabetes) Cohort:

Age 18 years old or older
BMI ≥ 30 kg/m2
Baseline HbA1c \< 6.5%
≥ one HbA1c value up to 6 months (+ 90 days) prior to index date
≥ one body weight value up to 6 months (+ 90 days) prior to index date
Initiated injectable semaglutide and switched from injectable semaglutide to tirzepatide between January 1, 2022, and December 31, 2025
Use of injectable semaglutide for ≥ 3 months
Seen by an LMC endocrinologist in the last 18 months as of the query date
Informed data consent for their medical record data to be used for research purposes

Exclusion criteria

Exclusion Criteria:

Clinical diagnosis of type 1 diabetes or latent autoimmune diabetes in adults
Prior use of tirzepatide
Were pregnant at the time of semaglutide initiation or semaglutide-to-tirzepatide switch or became pregnant during follow-up period
Bariatric surgery

Study design

Observational model: Cohort
Time perspective: Retrospective
Enrollment: 650 participants (estimated)
Patient registry: No

Groups and cohorts

T2D Switch TZP Cohort
adults living with T2D who switched from injectable semaglutide to tirzepatide
Drug: Tirzepatide
Obesity Switch TZP Cohort
adults living with obesity without diabetes, who switched from injectable semaglutide and to tirzepatide
Drug: Tirzepatide
T2D SEMA Cohort
adults living with T2D who were prescribed injectable semaglutide and did not switch to tirzepatide

Interventions

DrugTirzepatide
Only the T2D and obesity (non-T2D) Tirzepatide switch cohorts will be using this intervention

What researchers measure

Primary outcomes

Change from Baseline in Body Weight at 12 Months - T2D Switch TZP Cohort
Change in body weight (kg) at 6-12-month follow-up (closest observation to 12 month follow-up, ±6 weeks) compared to baseline (closest observation to the index date, ±6 weeks) among individuals living with T2D who switched from injectable semaglutide to tirzepatide during the index period.
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Body Weight at 12 Months - Obesity Switch TZP Cohort
Change in body weight (kg) at 6-12-month follow-up (closest observation to 12 month follow-up, ±6 weeks) compared to baseline (closest observation to the index date, ±6 weeks) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide during the index period.
Time frame: Baseline to follow-up (6-12 months)

Secondary outcomes

Change from Baseline in HbA1c at 12 Months - T2D Cohort
Change in HbA1c among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Percent Body Weight at 12 Months - T2D Cohort
Change in percent body weight (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Body Mass Index (BMI) at 12 Months - T2D Cohort
Change in BMI (kg/m\^2) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Blood Pressure at 12 Months - T2D Cohort
Change in blood pressure (mmHg) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Waist Circumference at 12 Months - T2D Cohort
Change in waist circumference (cm) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Estimated Glomerular Filtration Rate (eGFR) at 12 Months - T2D Cohort
Change in eGFR (ml/min/1.73m\^2) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Urine Albumin-to-Creatinine Ratio (uACR) at 12 Months - T2D Cohort
Change in uACR (mg/mmol) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Alanine Transaminase (ALT) at 12 Months - T2D Cohort
Change in ALT (U/L) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Lipids at 12 Months - T2D Cohort
Change in lipids (mmol/L) among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Insulin use (none, basal only, basal-bolus) - T2D Cohort
insulin use among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Number of Antihyperglycemic Agents (AHAs) at 12 Months - T2D Cohort
number of AHAs at 6-12 months follow-up among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Follow-up (6-12 months)
Proportion of Individuals who Discontinued Treatment during Follow-up Period (6-12 Months) - T2D Cohort
Proportion of individuals who discontinued treatment during follow-up period among individuals living with T2D who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with T2D maintaining semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Percent time in range (TIR) at 12 Months - T2D Cohort
Percent TIR (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using continuous glucose monitoring (CGM)
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Percent Time Above Range (TAR) at 12 Months - T2D Cohort
Change in percent TAR (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Percent Time Below Range (TBR) at 12 Months - T2D Cohort
Change in percent TBR (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Percent TBR in Level 2 Hypoglycemia at 12 Months - T2D Cohort
Change in percent TBR level 2 (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Percent Time In Tight Range (TITR) at 12 Months - T2D Cohort
Change in percent TITR (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Mean glucose at 12 Months - T2D Cohort
Change in mean glucose (mmol/L) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Glycemic Variability at 12 Months - T2D Cohort
Change in glucose variability (SD and CV) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)
Percent sensor capture at 12 Months - T2D Cohort
Percent sensor capture (%) among individuals living with T2D who switched from injectable semaglutide to tirzepatide, using CGM
Time frame: Baseline to follow-up (6-12 months)

Other outcomes

Change from Baseline in Percent Body Weight at 12 Months - Obesity Cohort
Change in percent body weight (%) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in BMI at 12 Months - Obesity Cohort
Change in BMI (kg/m\^2) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in HbA1c at 12 Months - Obesity Cohort
Change in HbA1c among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Blood Pressure at 12 Months - Obesity Cohort
Change in blood pressure (mmHg) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Waist Circumference at 12 Months - Obesity Cohort
Change in waist circumference (cm) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in eGFR at 12 Months - Obesity Cohort
Change in eGFR (ml/min/1.73m\^2) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in uACR at 12 Months - Obesity Cohort
Change in uACR (mg/mmol) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in ALT at 12 Months - Obesity Cohort
Change in ALT (U/L) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)
Change from Baseline in Lipids at 12 Months - Obesity Cohort
Change in lipids (mmol/L) among individuals living with obesity (non-diabetes) who switched from injectable semaglutide to tirzepatide and a propensity score-matched group of individuals living with obesity (non-diabetes) maintaining injectable semaglutide
Time frame: Baseline to follow-up (6-12 months)

Study locations

1 site

LMC Diabetes & Endocrinology Ltd.
Toronto, Ontario M4G 3E8, Canada

References and documents

Individual participant data

Plan to share: No — This is an observational study using registry data. IPD will not be shared.

No publications or documents are linked to this record.

Timeline

1 registry update since Sep 25, 2026

ElapsedEstimatedEstimated, not yet reached

Started Oct 2026 (actual). Primary completion is estimated for Dec 2026, 2 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered: Oct 15, 2026
First posted: Oct 22, 2026
StartActual: Oct 15, 2026
Primary completionEst.: Dec 2026
CompletionEst.: Jun 2027
Last update: Oct 22, 2026

What these dates mean

Start.: When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.: When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.: When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.: Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.

Registered

First appeared on the registry. No changes since

Oct 22, 2026

Show all 1 update

Oct 22, 2026
First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

Registry details

Key details

Study ID: NCT07889453
Lead sponsor: LMC Diabetes & Endocrinology Ltd.
Collaborators: Eli Lilly and Company
Responsible party: Sponsor
First posted: Oct 22, 2026
Start date: Oct 15, 2026
Primary completion: Dec 2026 (estimated)
Completion: Jun 2027 (estimated)
Last update: Oct 22, 2026

Oversight

Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No

View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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