A Study of Tirzepatide (LY3298176) Versus Insulin Degludec in Participants With Type 2 Diabetes

Inclusion Criteria:

- Participants must:

- Have been diagnosed with type 2 diabetes mellitus (T2DM)

- Have HbA1c between ≥7.0% and ≤10.5%

- Be on stable treatment with unchanged dose of metformin or metformin plus an
SGLT-2 inhibitor for at least 3 months before screening

- Be of stable weight (± 5%) for at least 3 months before screening

- Have a BMI ≥25 kilograms per meter squared (kg/m2) at screening

Exclusion Criteria:

- Participants must not:

- Have type 1 diabetes mellitus

- Have had chronic or acute pancreatitis any time prior to study entry

- Have proliferative diabetic retinopathy or diabetic maculopathy or
nonproliferative diabetic retinopathy requiring acute treatment

- Have disorders associated with slowed emptying of the stomach, or have had any
stomach surgeries for the purpose of weight loss

- Have acute or chronic hepatitis, signs and symptoms of any other liver disease,
or blood alanine transaminase (ALT) enzyme level >3.0 times the upper limit of
normal (ULN) for the reference range, as determined by the central laboratory.
Participants with nonalcoholic fatty liver disease (NAFLD) are eligible for
participation in this trial only if there ALT level is ≤3.0 the ULN for the
reference range

- Have an estimated glomerular filtration rate <45 mL/minute/1.73 m2 (or lower than
the country specific threshold for using the protocol required dose of metformin
per local label)

- Have had a heart attack, stroke, or hospitalization for congestive heart failure
in the past 2 months

- Have a personal or family history of medullary thyroid carcinoma or personal
history of multiple endocrine neoplasia syndrome type 2

- Have been taking any other diabetes medicines other than metformin, or metformin
plus an SGLT-2 inhibitor during the last 3 months

- Have been taking weight loss drugs, including over-the-counter medications during
the last 3 months