1660-P: Efficacy and Safety of Tirzepatide for the Treatment of Obesity in Adults with Type 1 Diabetes—The Mayo Clinic Experience

Abstract

Introduction: The efficacy and safety of tirzepatide for the treatment of overweight/obesity are well established in adults with type 2, but not type 1, diabetes (T1D). We aim to evaluate the efficacy and safety of tirzepatide for the treatment of obesity in adults with T1D. Methods: This is a retrospective study of adults with T1D treated with tirzepatide for obesity. Exclusion criteria: tirzepatide use for <3 months, use of other antiobesity medications, and active malignancy. Endpoints: total body weight loss (TBWL) percentage at 3, 6, and 12 months of treatment; TBWL%, change in HbA1c, total daily insulin dose [TDD], and continuous glucose monitor parameters (time in-, above-, and below range [TIR, TAR, and TBR, respectively]) from baseline to last-follow-up; and incidence of side effects, severe hypoglycemia, and diabetes ketoacidosis (DKA). We used matched pair t-test to analyze data. Data are presented as median [IQR]. Results: We included 52 patients: 58% female, 98% White, age 50 years [39-58], BMI 36 kg/m2 [32-42]. TBWL at 3, 6, and 12 months was 6% [3-9] (n=44), 8% [5-15] (n=29), and 14% [7-22] (n=13), respectively (p<0.001 for all). From baseline to the last follow up, median time of 6 months [4-11], TBWL% decreased by 8% [5-14], Hba1c by 1% [0.2-1.8], TDD by 32% [6-45], and TAR by 28% [8-48], p<0.001 for all. TIR increased by 29% [3-55], p<0.001. There was a trend for a decrease in TBR of 32% [0-78], p=0.08. No episodes of severe hypoglycemia or DKA were recorded. The incidence of side effects was 26%, the most common was nausea (15%). Two patients (4%) discontinued tirzepatide due to side effects. Conclusion: In adults with T1D, tirzepatide led to significant weight loss, better diabetes control, and lower insulin requirements without causing severe hypoglycemia or DKA over the course of up to 12 months. The side effect profile mimicked what has been reported. These data support the effectiveness and safety of tirzepatide for the treatment of obesity in adults with T1D. Disclosure E. Tama: None. D. Bechenati: None. P. Bennett: Stock/Shareholder; Lilly Diabetes. A. McNally: Stock/Shareholder; Medtronic. R. Rivera: None. S. Fansa: None. D. Anazco: None. A. Acosta: Consultant; Amgen Inc., Regeneron Pharmaceuticals Inc., Nestlé Health Science, Structure Therapeutics, Inc., Boehringer-Ingelheim. Research Support; Vivus. Consultant; Currax. Other Relationship; Gila Therapeutics, Phenomix Sciences. Speaker's Bureau; Eli Lilly and Company. M.D. Hurtado: None. Funding K12AR084222