A Study of Investigational Tirzepatide (LY3298176) Doses in Participants With Type 2 Diabetes and Obesity

The study will include a screening period of up to 5 weeks. The primary endpoint will be at Week 44 with a tirzepatide extension until week 80. A safety follow up will be performed approximately 4 weeks after end of treatment.

Inclusion criteria

• Have a Body Mass Index (BMI) ≥35 kilogram/square meter (kg/m²) at screening.
• Have had stable body weight (±5%) during the 90 days preceding screening.
• Have been diagnosed with Type 2 Diabetes (T2D).
• Have been on a stable treatment of metformin only at least 90 days preceding screening and between screening and randomization with the minimum effective dose of ≥1500 milligram (mg)/day.

Exclusion criteria

• Have Type 1 Diabetes (T1D), history of ketoacidosis or hyperosmolar state/coma, or any other types of diabetes except T2D.
• Have had 1 or more episode of severe hypoglycemia and/or 1 or more episode of hypoglycemia unawareness within 6 months prior to screening.
• Are currently receiving or planning to receive treatment for diabetic retinopathy and/or macular edema.
• Have a prior or planned surgical treatment for obesity.
• Use products intended for weight loss including prescription drugs, over the counter (OTC) drugs, and herbal preparations, within 3 months prior to screening.
• Have renal impairment measured as estimated glomerular filtration rate (eGFR) <45 milliliter/min (mL/min)/1.73 m².
• Have any of the following cardiovascular (CV) conditions within 2 months prior to screening.

• acute myocardial infarction.
• cerebrovascular accident (stroke).
• unstable angina .
• hospitalization due to congestive heart failure, or
• coronary artery revascularization.
• Have a family or personal history of medullary thyroid carcinoma or multiple endocrine neoplasia (MEN) syndrome Type 2.
• Have a history of chronic or acute pancreatitis.