2094-P: The Effects of Glucagon-Like Peptide 1 Receptor Agonists on Body Composition in Youth-Onset Type 2 Diabetes: Six-Month Outcomes

Introduction and Objective: Glucagon like peptide-1 receptor agonist (GLP-1 RA) therapy used for treatment of youth-onset type 2 diabetes (T2D) is relatively new. Emerging data suggests weight loss with GLP-1 RA may not be attributed solely to fat loss, but also potential skeletal muscle mass loss, a potentially adverse metabolic outcome. Our study aimed to analyze body composition in youth with T2D who started GLP-1 RA therapy. Methods: We used InBody 270 scans to measure skeletal muscle mass (SMM, kg), skeletal muscle mass percentage (SMM%, %), body fat mass (BFM, kg), and body fat mass percentage (BFM%, %) pre (n=23) and 6-months post (n=14) initiation of GLP-1 RA medication. Paired t-tests were used to assess changes where complete pairs existed (n=14). Results: At baseline, youth with T2D were 47.8% Black/African American, 43.5% white and 95.7% non-Hispanic, had a mean (SD) age of 17. 0 (3.3) years and BMI of 40.1 (7.5) kg/m2. Over 6 months HbA1c improved significantly, 7.3 (1.5) to 6.7 (1.1)%, p=0.02 and BMI z-score increased slightly 2.57 (0.57) to 2.74 (0.71), p=0.86. There was no significant loss of SMM (change of -0.12(1.90), p=0.81), SMM% (change of +0.23 (1.27), p=0.52), but also no significant changes in BFM (change of -0.89 (5.07), p=0.52) or BFM% (change of -0.41(2.10), p=0.48). Interestingly, when n=3 youth on tirzepatide were compared to n=11 on dulaglutide, those on tirzepatide lost BFM (change of -3.40 (2.84)) and BFM% (change of -1.13 (1.03)), while maintaining SMM% (change of +0.57 (1.13)) as compared to youth on dulaglutide who gained BFM (change of +0.98 (3.39)) and BFM% (change of +0.25 (1.98)) and experienced mild SMM% loss (change of -0.10 (1.17)). Conclusion: Preliminary analyses of 6-month GLP-1 RA use in youth with T2D shows no significant changes in body composition. Initial analysis may suggest beneficial effects of tirzepatide though sample size is limited. Ongoing data collection and 12-month study data will evaluate the influence of behavioral (exercise and eating) habits and metabolic markers (lipids, liver enzymes). Disclosure L.R. Schaaf: Advisory Panel; Ended; Novo Nordisk. R.A. Tracy: None. A. Schueler: None. H. Eisenmann: None. S. Rusk: None. M. Sewell: None. A. Shah: Consultant; Ended; AbbVie Inc. Funding Cincinnati Children's Carolyn Stoll Nursing Research Grant