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Tirzepatide Helps T1Ds with Weight Management

by, IDS Intern, Krystal Bosenbark, MPH, MS

For decades, insulin has been the main method that many people with type 1 diabetes (T1Ds) depend on to lower blood glucose. Since its inception, there have been numerous and incredible advancements in diabetes management. For example, there are insulin analogs that now go from longer-acting to ultra-rapid-acting insulin, as well as technologies like continuous glucose monitoring devices, insulin pumps, and hybrid closed looped systems.

Despite these advancements and their ability to work together to lower HbA1cs, many people still encounter the same side effects of insulin use: overweight and obesity. It is well-known that insulin use can be associated with weight gain in some individuals, especially soon after diagnosis and the start of treatment.

One study estimates that nearly half of United States adults with type 1 diabetes is either overweight or obese. Recently, many medications that are only approved for use in people with type 2 diabetes for diabetes and weight management are increasingly being used in the T1D population, as well as the general population. GLP-1s, SGLT2 inhibitors, and combinations of these medications with other glucose-lowering drugs are now widely used to lower glucose levels and aid in weight loss for desiring T1Ds. However, there are not many studies examining the weight management effects on those in this population.

tirzepatide and weight loss

A new study published in Diabetes Technology & Therapeutics aimed to bridge this gap. Similar to others in this drug class, Tirzepatide is FDA-approved only for those with type 2 diabetes, and its use is permitted for improving glucose control, promoting weight loss, and improving cardiovascular disease outcomes.

In their retrospective study, Garg et al. followed 62 overweight/obese T1D participants who had taken Tirzepatide and 37 overweight/obese T1D participants who had not taken the drug and were also not using other weight-loss medications over a 1-year follow-up period.

Results showed that compared to the control group, the Tirzepatide-treated group experienced large reductions in body mass index (BMI) and total body weight over each time point within the 1-year follow-up. 

This resulted in an average weight loss of over 46 pounds for this group. Among those in this treatment group, HbA1c decreased as quickly as three months after Tirzepatide was started, and participants were able to maintain this lowered HbA1c throughout the observation period. Similarly, insulin dose also decreased within three months of the study starting, and participants were also able to retain these reduced insulin dosing requirements for the remainder of the follow-up. Other glucose management metrics such as time in range, time above range, and glucose variation improved among those in the treatment group as well. Notably, there were no reports of hospitalizations related to severe hypoglycemia or diabetes ketoacidosis during the 1-year follow-up period.

Although drugs like Tirzepatide are approved solely for type 2 diabetes patients, findings from this study support the clinical use of this and similar drugs in the type 1 diabetes population. More comprehensive studies are needed to examine the drug’s safety and efficacy, but the results from Garg and coauthors are certainly steps in the right direction.

If you’d like to learn more about Tirzepatide and medications like it, we encourage you to reach out to your healthcare provider or one of the clinicians at Integrated Diabetes Services to discuss your options.

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