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Many people who live with type two diabetes struggle to effectively control their glucose and weight levels with current treatment options. Finding better ways to help people who live with type two diabetes matters. SURPASS SWITCH evaluates the efficacy and safety of switching from a once-weekly dose of dulaglutide to a once-weekly dose of tirzepatide for adults with type two diabetes. The study is enrolling approximately two hundred and fifty participants with type two diabetes who are inadequately controlled with either point seven five or one point five milligrams of dulaglutide. Eligible participants may also be taking no, or up to three background oral antihyperglycemic medications. Participants will be randomly assigned to one of two study arms, and stratified according to several different factors. One arm will continue with weekly dulaglutide and escalate to four point five milligrams or the maximum tolerated dose. The other study arm will switch participants from dulaglutide to a weekly dose of tirzepatide and escalate to fifteen milligrams or the maximum tolerated dose. Angelo and Cho are two candidates who fit the study profile. They both decide to enroll. Let’s follow their experience to gain a better understanding of the participant journey. All participants begin with the three-week screening period, where candidates sign informed consent forms, complete medical histories, physical examinations and blood draws for laboratory tests. During the screening period, Angelo and Cho receive diabetes education, counseling, and training on how to conduct self-monitoring of blood glucose. They will be given a glucometer, related supplies, and an e-Diary to use throughout the study. Before entering the treatment period at visit three, Angelo and Cho will see an ophthalmologist or optometrist for a dilated fundoscopic eye examination. Both understand they are committing nearly a year to this endeavor. But participating in the trial means regular visits for complete diabetes care, regardless of which treatment arm they are assigned to. AND they will receive medical support throughout the trial. Angelo and Cho are both eager to get started. Angelo and Cho complete the screening procedures and meet all eligibility criteria during visit three. They are randomized to either escalated dosages of dulaglutide, or to begin taking tirzepatide for the forty-week treatment period. The study is open label, so the participants and the study team will know which treatments they are taking. Angelo is randomized to the tirzepatide arm. He will administer a subcutaneous injection on the same day each week, starting with the two point five milligram dose that is escalated by two point five milligrams every four weeks until he reaches fifteen milligrams or his maximum tolerated dose. Cho is randomized to the intensified dulaglutide care arm. Her once-a-week dosage will also escalate every four weeks until she reaches four point five milligrams per week or her maximum tolerated dose. Both participants’ treatment period experience is similar. They collect their seven-point self-monitored blood glucose levels according to the schedule of activities, and check fasting blood glucose at least twice a week. They record those values in their e-Diaries and also record any hyper- or hypoglycemic events. Their visits are similar. For on-site fasting visits, they arrive having fasted for at least eight hours. They do not eat or drink anything other than water and avoid significant physical activity before these visits. Throughout the treatment period, Angelo and Cho also have physical exams and regular blood draws for lab tests. They will have E-C-Gs and will fill out patient-reported outcomes questionnaires to track their quality of life and well-being throughout the treatment period: at visit three, visit eleven, and for early discontinuation if needed. Approximately four weeks after they complete their last study visits, Angelo and Cho each return for a safety follow-up visit. They return their e-Diaries and study supplies to the sites. They also have blood draws for a few more lab tests, and a final E-C-G. Angelo and Cho’s commitment to the study process may benefit not only their own health, but others who face the challenges of type two diabetes. Thank YOU for bringing care and expertise to SURPASS SWITCH. You are helping advance an innovative new medicine that may improve health outcomes and treatment options for people with diabetes worldwide.