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The FDA approved Zepbound (a tirzepatide injection), as the first weight-loss treatment to activate both GIP (glucose- dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) hormone receptors

3,4 American Association of Clinical Endocrinology guidelines recommend treatment with GLP-1RA in T2DM patients with coexisting ASCVD, high-risk for ASCVD, heart failure, or chronic kidney disease regardless of their glycemic control due to their organ protective effects

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Ussher JR, Drucker DJ: Cardiovascular actions of incretin-based therapies

The position document summarized that the efficacy of DPP-4 inhibitors to lower glucose is intermediate when compared to other therapies, that DPP-4 inhibitors are neutral in relation to change in body weight, that major side effects are rarely seen for DPP-4 inhibitors, that the risk for hypoglycemia is low and that the cost is high