P-147: Targeting the tough duo: tirzepatide in obese adolescents with type 1 diabetes on advanced hybrid closed-loop system
N Elbarbany, S AbouelnasrAbstract
Introduction
Obesity in T1DM young adults presents a dual clinical challenge, contributing to increased insulin resistance and suboptimal glycemic control.
Objectives
This study evaluated the efficacy of tirzepatide as adjunct therapy for weight management and glycemic outcome in obese T1DM participants using MiniMed ™ 780G insulin pump.
Methods
This observational study was conducted on 14 young adults ( mean age 17.8±5.6years ) with T1DM and obesity, treated with weekly subcutaneous tirzepatide over 6 months. Clinical and metabolic data were collected including BMI, GMI, time in range (TIR), time above range (TAR), total daily insulin dose, bolus and autocorrection insulin usage and glucose variability.
Results
After 6 months of tirzepatide therapy, significant improvements were observed. Mean BMI decreased from 32.4 to 27.0 kg/m2 (p < 0.001), GMI improved from 8.0% to 7.1% (p < 0.01). Time in Range (70–180 mg/dL) increased from 42% to 72% (p < 0.001), while TAR declined from 31% to 18.9% (p < 0.01), TBR remained stable at 1%, indicating no increased hypoglycemia risk. Total daily insulin requirements, auto basal insulin, bolus insulin, autocorrection insulin dropped significantly((p < 0.05 for all). Glucose variability improved, from 38.2% to 36.0% (p=0.335). There were no reported hospitalizations from severe hypoglycemia or diabetic ketoacidosis. Tirzepatide was generally well tolerated with mild GIT side effects.
Conclusions
Tirzepatide(off label) use demonstrated efficacy in reducing BMI, total insulin requirement and improving glycemic control in obese T1DM with no observed increase in hypoglycemia. These findings suggest tirzepatide may be a promising adjunct therapy in this challenging population and warrant further investigation in larger controlled trials.