TRANSCEND-T2D-2: Type 2 Diabetes Insulin Combination Trial

Study Overview

TRANSCEND-T2D-2 evaluates retatrutide as an add-on therapy for patients with type 2 diabetes who are not achieving adequate glycemic control with basal insulin. This population represents a significant unmet need — millions of patients remain above HbA1c targets despite insulin use, and adding medications that also promote weight loss (rather than weight gain) is a key therapeutic goal.

Study Design

Population

Adults with type 2 diabetes:

• Currently on stable basal insulin (with or without metformin)
• HbA1c 7.0-10.0%
• BMI ≥25 kg/m²

Key Question

Can retatrutide improve glycemic control in insulin-treated patients while also reducing body weight and potentially allowing insulin dose reduction?

Endpoints

Primary: HbA1c change from baseline Key secondary:

• Insulin dose reduction
• Body weight change
• Hypoglycemia incidence
• Proportion achieving HbA1c <7% without clinically significant hypoglycemia

Clinical Context

Insulin therapy often causes weight gain (typically 2-4 kg), creating a vicious cycle in patients with T2D and obesity. A therapy that improves glycemic control while enabling weight loss and insulin dose reduction would represent a major advance for this population.