AIMS: To evaluate the effectiveness and safety of tirzepatide on glycaemia, weight, and markers of cardiometabolic risk in people with type 1 diabetes and obesity. MATERIALS AND METHODS: ) initiated on tirzepatide against 50 age-, sex- and BMI-matched controls. Outcomes included changes in HbA1c, weight, total daily dose of insulin, cardiometabolic markers, and safety data including hospitalisations over 12 months. RESULTS: , HbA1c 64.3 mmol/mol, 32% male) were followed up for a median of 365 days. The median tirzepatide dose (72.4%) was 5 mg weekly. Compared to controls, the tirzepatide group achieved significant mean reductions in: HbA1c (6.5 mmol/mol 95% CI 3.8-9.1, p < 0.001) (0.6% 0.4-0.8), weight (13.4 kg 11.0, 15.8, p < 0.001) and total daily insulin dose (29.9 units 16.9, 42.9, p < 0.001). Significant improvements were observed in systolic blood pressure (12.6 mmHg, p < 0.001), diastolic blood pressure (4.1 mmHg, p = 0.034), total cholesterol (0.8 mmol/L, p < 0.001), non-HDL cholesterol (0.6 mmol/L, p < 0.001) and triglycerides (0.7 mmol/L, p < 0.001) compared to controls. While side effects were common, 89.4% continued on tirzepatide at 1 year. There was no between-group difference in severe hypoglycaemia, ketoacidosis nor hospitalisation rates. CONCLUSIONS: In a real-world setting, tirzepatide significantly improves glycaemia, weight, and markers of cardiometabolic risk in people with type 1 diabetes and obesity with a reassuring safety profile. These findings warrant large-scale RCTs to evaluate long-term cardiovascular outcomes in this high-risk population.
Berry et al. (Mon,) studied this question.
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