Tirzepatide Leads to Significant Weight Loss and Better Heart & Kidney Health in Type 1 Diabetes: Study Finds

In the study published in Diabetes Technology & Therapeutics, participants experienced an average weight reduction of more than 23%, demonstrating the drug’s effectiveness in managing obesity alongside T1D. Improved glucose regulation was also observed, further supporting its potential role in diabetes management.

Excess weight and obesity impact nearly two-thirds of adults with type 1 diabetes, making it harder to control blood sugar and increasing the risk of heart and kidney diseases. The researchers note that while newer medications like tirzepatide and sodium-glucose cotransporter-2 inhibitors are approved for type 2 diabetes patients with these complications, their effects on T1D remain unclear. In this study, Satish K. Garg, Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado, USA, and colleagues assessed cardiovascular and kidney biomarkers in overweight and obese adults with T1D who were treated with tirzepatide for 21 months, despite its off-label use.

For this purpose, the researchers conducted a retrospective chart review of 84 overweight and obese adults with type 1 diabetes who had been prescribed tirzepatide since July 2022 and had used it for at least six months. A control group of 38 individuals was matched based on age, diabetes duration, sex, HbA1c, and BMI. Data were collected from electronic medical records before starting tirzepatide and throughout the 21-month treatment period.

Researchers used linear mixed effects models to analyze changes in lipid levels, blood pressure, and kidney function (measured by estimated glomerular filtration rate) over time in those treated with tirzepatide compared to controls.

Based on the study, the researchers reported the following findings:

• Tirzepatide users had a slightly higher baseline BMI than controls (35.2 ± 4.8 kg/m² vs. 33.3 ± 4.2 kg/m²).
• Over 21 months, tirzepatide users lost significantly more weight (−59 ± 4.6 lbs, −23.4%) compared to a slight weight gain in controls (+1.7 ± 5.0 lbs, +1.8%).
• HbA1c reduction was greater in tirzepatide users (−0.50 ± 0.07%) than in controls (−0.24 ± 0.09%).
• There were significant improvements in total cholesterol, LDL cholesterol, triglycerides, systolic blood pressure, and kidney function (eGFR) in tirzepatide users.
• These improvements remained significant even after adjusting for weight loss and HbA1c reduction.
• eGFR declined in controls but remained stable in those using tirzepatide.

The study revealed that long-term use of tirzepatide in overweight and obese adults with type 1 diabetes led to over 23% weight loss and sustained glucose control. Regardless of weight or HbA1c changes, significant improvements were observed in cardiovascular and kidney function markers, starting as early as three months and continuing throughout the study.

"These findings highlight tirzepatide’s potential as an effective adjunct therapy for type 1 diabetes management. A long-term randomized controlled trial is strongly recommended to confirm these benefits and expand treatment options for patients with type 1 diabetes," the authors concluded.

Reference: https://doi.org/10.1089/dia.2024.0481