Tirzepatide in Type 1 Diabetes in Combination with Viral Shah, MD

Tilzepatide, the first FDA-approved dual GLP-1/GIP agonist, has gained attention from both the medical community and the general public over the past 18 months. Fueled by news and updates on the use of this drug in type 2 diabetes and weight management, this drug has become one of the most discussed drug treatments of 2023.

The drug continues to be a hot topic in 2024, with a study published in late January suggesting it could be used in patients with type 1 diabetes.Arrive within 6 months of New England Medical Journal This publication provides insight into the effects of semaglutide in type 1 diabetes, and a proof-of-concept study examining the use of tirzepatide led by Viral Shah, MD, of Indiana University, shows that evidence surrounding the use of the GLP-1 receptor We have further strengthened the foundation of Agonists in the management of type 1 diabetes.

In a single-center retrospective observational study from the University of Colorado Anschutz Barbara Davis Diabetes Center, Shah et al. identified a cohort of 26 adults with type 1 diabetes at the time of initiation of tirzepatide for another indication. The main outcomes of interest in this study were the reduction in her HbA1c compared to baseline measurements and the percentage change in her weight after 8 months. The researchers also assessed changes in her CGM measures and her BMI as secondary outcomes of interest.

The analysis showed a significant reduction in HbA1c among the study cohort, with reductions of 0.45% and 0.59% observed at 3 and 8 months, respectively. When body weight was assessed, decreases of 3.4%, 10.5%, and 10.1% were observed at 3, 6, and 8 months after starting tirzepatide.

Analysis of secondary outcomes revealed that both time points were within the target range of 70 to 180 mg/dL (+12.6%; P=.002), time in the narrow target range of 0 to 140 mg/dL increased over 3 months (+10.7%; P=.0016) After 3 months, these changes persisted for an 8-month follow-up period. Similarly, time improvements over the 180 mg/dL range were observed in his 3 months and persisted through his 8th month. When evaluating safety results, the results suggested that the drug was relatively safe and well-tolerated, as only two of his patients discontinued use during follow-up. .

In this episode, Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives Natalie Bellini, DNP, Diabetes Technology Program Director, University Hospitals Diabetes and Metabolic Care Center, and Diana, DNP, Endocrine Clinical Pharmacist, Diabetes Technology Education and Training Director, and Co-Director of Endocrine Disorders in Pregnancy at Cleveland.・We welcome Dr. Isaacs. Mr. Shah will be joined at the clinic to discuss this research, the prospects for GLP-1 RA-based treatments in type 1 diabetes, and the potential role of tirzepatide in type 1 diabetes.

Disclosures related to Shah include Novo Nordisk, Dexcom Inc., Insulet Corporation, Tandem Diabetes Care, and others. Disclosures related to Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Bellini-related disclosures include Abbott Diabetes Care, MannKind, Prevention Bio, and more.

References:

1. _{^{Akturk HK, Dong F, Snell-Bergeon JK, Karakus KE, Shah VN. Efficacy and safety of tirzepatide in adults with type 1 diabetes: a proof-of-concept observational study. J Diabetes Science and Technology. Published online on February 5, 2024. doi:10.1177/19322968231223991}}
2. _{^{Campbell P. Tirzepatide (Mounjaro) receives FDA approval for type 2 diabetes. HCP live. May 13, 2022. Accessed February 15, 2024. https://www.hcplive.com/view/tirzepatide-wins-fda-approval-for-type-2-diabetes.}}
3. _{^{Campbell P. FDA approves tirzepatide (Zepbound) for chronic weight management. HCP live. November 8, 2023. Accessed February 15, 2024. https://www.hcplive.com/view/fda-approves-tirzepatide-zepbound-chronic-weight-management.}}
4. _{^{Dandona P, Chaudhry A, Ghanim H. Semaglutide in early type 1 diabetes. N English J Medicine. 2023;389(10):958-959. doi:10.1056/NEJMc2302677}}