11-PUB: Transitioning from Dulaglutide to Tirzepatide Improves Glycemic Control in Patients Undergoing Hemodialysis with Type 2 Diabetes—An Assessment by Continuous Glucose Monitoring

Introduction & Objective: Tirzepatide is a dual glucose-dependent insulinotropic peptide and glucagon-like peptide-1 receptor agonist. However, the efficacy and safety in patients undergoing hemodialysis remain unclear. Methods: We conducted a single-center retrospective study of patients with type 2 diabetes undergoing hemodialysis who were transitioned from dulaglutide to tirzepatide. We analyzed glucose levels using CGM. Results: Fourteen patients (61.9 ± 9.9 years, male: female=11:3) were included. After switching to tirzepatide, time in range increased to 50.8% from 42.7% (p=0.02) (Figure), time above range decreased to 37.8% from 48.4% (p=0.02), and mean glucose levels decreased to 137.4 mg/dL from 156.6 mg/dL (p=0.006). In contrast, there was no significant difference in time below range (11.3% and 8.9%) (p=0.75). Four patients experienced dyspnea (28.6%), and one patient experienced nausea (7.1 %); however, no critical adverse events were reported. Conclusion: Transitioning from dulaglutide to tirzepatide improved glycemic control without hypoglycemia in patients undergoing hemodialysis with type 2 diabetes.