Tirzepatide Shows Substantial Weight Loss for Patients With Type 1 Diabetes
Tirzepatide (Mounjaro, Zepbound), a glucagon-like peptide-1 (GLP-1) medication, demonstrates improved diabetes control and decreases in insulin requirements.
Tirzepatide (Mounjaro, Zepbound) demonstrated substantial weight loss, improved diabetes control, and decreased insulin need for adults with type 1 diabetes (T1D) with overweight and obesity. In a retrospective study published in Mayo Clinic Proceedings, investigators aimed to determine the effects of tirzepatide on weight, diabetes control, and insulin needs. Investigators also studied the safety profile and cardiometabolic parameters of tirzepatide for this patient population.1
Investigators also studied the safety profile and cardiometabolic parameters of tirzepatide for this patient population. | Image Credit: Douglas | stock.adobe.com
In an observational study published in the Journal of Diabetes Science and Technology, investigators found that tirzepatide did reduce hemoglobin A1c and body weight for adults, but randomized controlled trials would still be needed for efficacy and safety. “To our knowledge, this is the first study reporting efficacy and safety of tirzepatide in adults with T1D. Our pilot study found that tirzepatide was associated with significant improvement in glycemic outcomes and reduction in weight,” the study authors said.2
Individuals with T1D were included between June 1, 2022, and October 31, 2023, at Mayo Clinic, with 51 patients being included. Approximately 58.8% of patients were female and 96.1% were White. Patients included were 18 years or older and used weekly subcutaneous tirzepatide injection with overweight and at least 1 adiposity-associated disease or with obesity.
Data on demographic, arthrometric, clinical, and laboratory were collected.The primary end point was total body weight percentage at the last follow-up. Secondary end points included body weight percentage at 3, 6, 9, and 12 months of treatment, change in percentage of hemoglobin A1c, change in total daily insulin dose, change in basal and meal total insulin doses, and change in continuous glucose monitoring parameters. The incidence of adverse events was also included.1
The study authors reported that the total body weight loss was 8.5% for a median follow-up time of 8 months. At 12 months, the weight loss was 12.2%. By the last follow-up, investigators stated that 76.5% of patients had at least 5% of total body weight loss and, for patients with a 12-month follow-up, all achieved at least 5% of total body weight loss.
Hemoglobin A1c decreased by 0.9% and daily insulin requirements by 31.6%, with no increased incidence of hypoglycemia. Basal and bolus insulin needs also decreased, with more defined declines during the first 6 months of therapy. There was also an improvement in the cardiometabolic parameters. Investigators reported that there was a decrease in diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglycerides, and alanine aminotransferase, which were all significant. There was a trend for decreased systolic blood pressure, but it was not statistically significant.1
Approximately 29.4% of patients reported at least 1 adverse effect (AE), with the most common AE being nausea for 7 patients. Gastrointestinal symptoms were also reported, with 3 patients discontinuing therapy due to AEs and 4 required dose de-escalation. Further, there were 4 patients who reported hypoglycemia, but no patients needed assistance or discontinuation, and there were no reports of diabetic ketoacidosis.1
“Future studies are needed to ascertain the long-term effect of tirzepatide in this population, ideally focusing on cardiovascular outcomes,” the study authors stated.1
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References
1. Rivera Gutierrez R, Tama E, Bechenati D, et al. Effect of Tirzepatide on Body Weight and Diabetes Control in Adults With Type 1 Diabetes and Overweight or Obesity. Mayo Clin Proc. 2025;100(2):265-275. doi:10.1016/j.mayocp.2024.07.006
2. Akturk HK, Dong F, Snell-Bergeon JK, Karakus KE, Shah VN. Efficacy and Safety of Tirzepatide in Adults With Type 1 Diabetes: A Proof of Concept Observational Study. J Diabetes Sci Technol. Published online February 5, 2024. doi:10.1177/19322968231223991
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