12-PUB: Tirzepatide—Efficacy, Safety, and Satisfaction in Real World Type 2 Diabetes Application in Japan

To analyze the efficacy and safety of Tirzepatide (Tir) in improving blood glucose control in clinical practice. People with type 2 diabetes who received Tir for 8 months from April 2023, were retrospectively evaluated for changes in HbA1c and given a satisfaction survey. Of the 94 people (49 males, age 63±15 years, BMI 25.3±6.7, starting HbA1c 8.1±1.7 %, 25 people on insulin), 2 were on Tir 10 mg, 3 on 7.5 mg, and the rest on ≤5 mg. HbA1c decreased on average 1.7±1.7 % and 8 were weaned from insulin therapy. Eight had no change in HbA1c or a worsening of around 0.55% on average due to oral medications or insulin dose reductions. Ten ceased Tir therapy, 3 of which achieved effective target HbA1c and were weaned at their request, 1 had large weight loss, 1 experienced hypoglycemia due to combined use with insulin and preferred to discontinue Tir rather than reduce insulin dosage, 5 experienced gastrointestinal symptoms, and 1 changed to a GLP1 formulation due to infrequent hospital visits. In one case, sleep apnea improved, and one person with Alzheimer's disease and uncontrolled food intake achieved a healthy level of food intake. One person with Prader-Willi syndrome could not reach target HbA1c due to dietary restriction limitations caused by possible insufficient Tir dosage. In the survey, 80% were satisfied, 50% would recommend the treatment to others due to superior overall results and weight loss, and 50 % stipulated unwillingness in recommending it to others, although satisfied, due to uncertainty over the effectiveness in others. Two percent were dissatisfied. Eighty percent of respondents indicated continued treatment. In comparison to their previous therapies, 90% felt healthier and more active, that Tir was a better fit and didn't place a burden on their daily lives, and that it was successful in controlling body weight. Further observation is needed.