No current GLP-1 label lists prediabetes as an approved use, so prescribing one for it would be off-label. SURMOUNT-1, three years (Tirzepatide): Among people with obesity and prediabetes, 1.3% on tirzepatide were diagnosed with type 2 diabetes by week 176 against 13.3% on placebo. After 17 weeks off treatment it was 2.4% against 13.7%. ClinicalTrials.gov lists 36 trials of these medicines on it: 14 with posted results and 6 recruiting now.
Read from the registry and PubMed every day. The newest update here is Nov 5, 2026.
Each read in the paper's abstract on Nov 6, 2026. Trials differ in who took part and how long they ran.
Tirzepatide · 1,032 people · Better than the comparison · Placebo-controlled randomized trial
Among people with obesity and prediabetes, 1.3% on tirzepatide were diagnosed with type 2 diabetes by week 176 against 13.3% on placebo. After 17 weeks off treatment it was 2.4% against 13.7%.
Semaglutide · 207 people · Better than the comparison · Placebo-controlled randomized trial
At week 52, 81% on semaglutide 2.4 mg had returned to normal blood sugar against 14% on placebo.
A trial counts when the registry's conditions or title name this, and some study a related question, such as insulin sensitivity in people with the condition. A registered trial shows a question being asked, not that the answer is yes.
| Medicine | Trials | Posted results | Recruiting |
|---|---|---|---|
| Semaglutide | 13 | 2 | 5 |
| Exenatide | 10 | 7 | 0 |
| Liraglutide | 10 | 5 | 0 |
| Mazdutide | 1 | 0 | 0 |
| Orforglipron | 1 | 0 | 1 |
| Tirzepatide | 1 | 0 | 0 |
Latest phases and largest trials first. Each result is the first primary outcome as its sponsor posted it to the registry, which is not peer review.
| Trial | Medicine | Phase | People | Result |
|---|---|---|---|---|
| NCT01272219Effect of Liraglutide on Body Weight in Non-diabetic Obese Subjects or Overweight Subjects With Co-morbidities: SCALE™ - Obesity and Pre-diabetes | Liraglutide | Phase 3 | 3,731 | Change From Baseline in Fasting Body Weight (percent change), Week 0, Week 56. Liraglutide 3.0 mg (56-Week): -7.98; Liraglutide Placebo (56-Week): -2.62. |
| RISE AdultRISE Adult Medication Study | Liraglutide | Phase 3 | 267 | Insulin Sensitivity, M/I (x 10-5 mmol/kg/min per pmol/L), 3-months after a medication washout. Metformin Alone: 3.53; Glargine Followed by Metformin: 3.38; Placebo: 3.63; Liraglutide + Metformin: 3.49. |
| STEP 10Research Study Looking at How Well Semaglutide Works in People Living With Obesity and Prediabetes | Semaglutide | Phase 3 | 207 | Change in Body Weight (Percentage [%]) (Percentage (%) of body weight), From randomisation (week 0) to end of treatment (week 52). Semaglutide 2.4 mg: -14.4; Placebo: -2.7. |
| NCT01234649Combined Liraglutide and Metformin Therapy in Women With Previous Gestational Diabetes Mellitus (GDM) | Liraglutide | Phase 3 | 153 | Insulin Secretion-Sensitivity Index (IS-SI) (index), 84 weeks of treatment. Metformin XR Plus Liraglutide: 418.4; Metformin XR Plus Placebo: 333. |
| NCT01784965Liraglutide and a Calorie Restricted Diet Augments Weight Loss and Decreases Risk of Type 2 Diabetes and CVD. | Liraglutide | Phase 3 | 69 | Change in Weight Reported at 14 Weeks (kg), Baseline and 14 weeks. Placebo: -3.3; Liraglutide: -6.8. |
| NCT03101930Cardiovascular Effects of GLP-1 Receptor Activation | Liraglutide | Phase 4 | 329 | Change in Flow-mediated Dilation (Percentage), Baseline to 2 and 14 weeks, Baseline to 2 weeks (Placebo infusion). Liraglutide: 0.71; Sitagliptin: 2.06; Hypocaloric Diet: 1.24. |
| NCT01181986The Study of Exenatide Action on Vessel Function in Type 2 Diabetes and Prediabetes | Exenatide | Phase 4 | 76 | Reactive Hyperemia Index (RHI) (ratio), 0, 2, 4, 6 and 8 hours on Day 11 (Sub-study 1); 0 and 120 minutes on test Days 1, 2 & 3 (Sub-study 2). Exenatide (Subs-study 1): 1.90; Placebo (Sub-study 1): 1.79; Saline+Exenatide (Sub-study 2): 2.24; Saline+Placebo (Sub-study 2): 1.95; Exendin-9+Exenatide (Sub-study 2): 1.99. |
| NCT00546728The Vascular Effects of Exenatide Versus Metformin in Patients With Pre-Diabetes | Exenatide | Phase 4 | 50 | Change in Reactive Hyperemic Index Over the 3-month Treatment Period (ratio), Change from baseline to 3 months. Exenatide: 0.01; Metformin: -0.17. |
| PIO-EXEffect of Pioglitazone and Exenatide on Body Weight and Beta Cell Function | Exenatide | Phase 4 | 43 | Effect of Pioglitazone, Exenatide and Combined Pioglitazone and Exenatide on Body Weight (kg), baseline and 6 months. PIOGLITAZONE: 5.5; EXENATIDE: 2.4; PIOGLITAZONE and EXNATIDE: 2.7. |
| NCT00456885The Effect of Exenatide on Weight and Hunger in Obese, Healthy Women | Exenatide | Phase 4 | 41 | Change in Weight (kilograms), 16 weeks after the beginning of each treatment. Exenatide: -2.49; Placebo: 0.43. |
| NCT02104739Effects of Antidiabetic Medications on the Postprandial State in Prediabetes | Exenatide | Phase 4 | 21 | Monocyte NfkB Levels as Detected by Western Blotting (NfkB p65 arbitrary units), baseline. Exenatide: 62.79; Saxagliptin: 72.03; Placebo: 67.68; Exenatide Extended-release (ER): 84.19. |
| NCT05786521Effect of GLP1 Receptor Agonists on Physical Function, Body Composition, and Markers of Aging in Older Adults | Semaglutide | Phase 4 | 20 | Lean Body Mass Change (g), Baseline to 20 weeks. Semaglutide and Lifestyle Intervention: -1730.6; Lifestyle Intervention: -421. |
| NCT01588418Acute Effect of Exenatide on Brain Glucose Metabolism | Exenatide | Phase 4 | 15 | On ClinicalTrials.gov |
| NCT00775684Effect of Exenatide, Sitagliptin or Glimepiride on Functional ß -Cell Mass | Exenatide | Not phased | 47 | Effect on Functional Beta-cell Mass as Determined by Change in ß-cell Secretory Capacity at 6 Months (μU/ml) (μU/ml), Baseline and 6 months, Acute Insulin Response (AIRmax)Baseline. Exenatide: 214; Sitagliptin: 149; Glimepiride: 133. |
The registry page names each site and who can enroll. Ask your clinician before joining one.
| Trial | Medicine | Phase | Expected to finish |
|---|---|---|---|
| A Study of Orforglipron in Participants With Overweight at Risk of Development of Obesity-Related Complications or Progression to Class 1 Obesity | Orforglipron | Phase 3 | Sep 2030 |
| Pharmacogenetics of the Response to GLP-1 in Mexican-Americans With Prediabetes | Semaglutide | Phase 4 | Oct 31, 2026 |
| Anti-atherosclerotic Efficacy of Selected Antidiabetic Drugs in Patients With Coronary Artery Disease and Pre-diabetes | Semaglutide | Phase 4 | Aug 1, 2029 |
| Genetics of the Acute Response to Oral Semaglutide | Semaglutide | Not phased | Dec 31, 2025 |
| A Clinical Trial to Examine the Efficacy and Safety of an Investigational Product With and Without Use of Semaglutide on Glycemic Response in Adults With Prediabetes or Type 2 Diabetes | Semaglutide | Not phased | Sep 2026 |
| Prevention of Progression of Prediabetes, Obesity and CV Risk | Semaglutide | Phase 1 | Jul 2027 |
Randomized trial · Diabetes Care · Oct 20, 2026 · Ganeshalingam AA et al.
Randomized trial · Diabetes Care · Sep 21, 2026 · Chen L et al.
Randomized trial · Diabetes Care · May 1, 2026 · Ganeshalingam AA et al. · cited by 2
Randomized trial · Am J Physiol Endocrinol Metab · Mar 4, 2026 · Fischer JS et al. · cited by 2
Meta-analysis · Diabetes Metab Res Rev · Jan 1, 2026 · Tsironikos GI et al. · cited by 1
Randomized trial · JAMA Psychiatry · Nov 1, 2025 · Ganeshalingam AA et al. · cited by 44
Listed from Europe PMC as published, newest first. A listing here is not a judgement of a study's quality or a recommendation.
Written from each source's own record as it changes. Every change on GLPcompare
SURMOUNT-1, three years (Tirzepatide, 1,032 people): Among people with obesity and prediabetes, 1.3% on tirzepatide were diagnosed with type 2 diabetes by week 176 against 13.3% on placebo. After 17 weeks off treatment it was 2.4% against 13.7%.
Not in any current label we read. A prescriber can still use a medicine off-label, but insurance often limits coverage to approved uses, so ask your plan.
Semaglutide, with 13 registered trials on it, then Exenatide with 10. More trials do not mean better results: read what each posted.
6 trials are recruiting on ClinicalTrials.gov now, listed below with their registry pages, which name each site and who can enroll.