Ghassan Salah Ahmed¹ , Adheed Khalid Al-Sharrad¹, Karamallah Al-Yousuf²

¹Department of Clinical Pharmacy,; ²Department of Pharmacology and Toxicology, College of Pharmacy, University of Basrah, Basrah, Iraq.

For correspondence:-  Ghassan Ahmed   Email: Ghassan.ahmed@uobasrah.edu.iq

Received: 31 May 2026        Accepted: 15 August 2026        Published: 31 August 2026

Citation: Ahmed GS, Al-Sharrad AK, Al-Yousuf K. Comparative effectiveness of semaglutide and tirzepatide in patients with type 2 diabetes mellitus. Trop J Pharm Res 2026; 25(8):1163-1171 doi: https://dx.doi.org/10.4314/tjpr.v25i8.13

© 2026 The authors.
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Abstract

Purpose: To investigate the effectiveness of semaglutide (Ozempic) and tirzepatide (Mounjaro) on weight reduction, glycaemic control, insulin resistance, and cardiometabolic parameters over 24 weeks in Iraqi patients with T2DM. Methods: This was a prospective, randomised, open-label, parallel-group study conducted at Al Fayhaa Teaching Hospital in Basra, Iraq, comprising 60 patients with T2DM (HbA1c: 7 – 10 %, BMI ≥ 30 kg/m²). The patients were randomised equally into 2 groups (n = 30). Group 1 received subcutaneous semaglutide (0.5 – 1.0 mg/week), and group 2 received tirzepatide (5 – 15 mg/week) for 24 weeks. Body weight, BMI, waist circumference, HbA1c, fasting plasma glucose (FPG), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), lipid profile, and adverse events were evaluated at baseline, week 12, and week 24. Results: Tirzepatide significantly reduced body weight, HbA1c, fasting plasma glucose (FPG), low density lipoprotein (LDL), triglycerides, and systolic pressure compared to semaglutide (p < 0.05). Furthermore, HOMA-IR was significantly reduced following treatment with tirzepatide (p < 0.05). There was no significant difference in overall adverse effects following treatment with tirzepatide and semaglutide (p > 0.05). Conclusion: Tirzepatide significantly reduces body weight, FPG, LDL, triglycerides, systolic pressure and decreases HOMA-IR with mild adverse effects.

Keywords: Glycaemic control, HOMA-IR, Insulin resistance, Semaglutide, Tirzepatide, Type 2 Diabetes Mellitus (T2DM)

Impact Factor
Thompson Reuters (ISI): 0.6 (2023)
H-5 index (Google Scholar): 49 (2023)