Introduction & Objective: Glucagon-like peptide receptor agonist (GLP-1R) semaglutide and a dual incretin agonist, tirzepatide are approved for the treatment of type 2 diabetes and obesity. However, little is known about the efficacy of GLP-1RA in T1D. This real-world study compared the efficacy of semaglutide and tirzepatide in adults with T1D.
Methods: Clinic patients with T1D who were treated with a GLP-1RA were identified from the electronic health record at the time of drug initiation and were followed up to 9 months. An age, sex, race and BMI-matched control group was selected from patients who were not treated with a GLP-1RA, matched to semaglutide users. Linear mixed models were used to compare anthropometric and glycemic outcomes over time by group.
Results: At baseline, HbA1c and total insulin dose were higher in controls than in both GLP-1RA groups, and BMI was higher in tirzepatide users (Table 1a). There was significantly more weight loss in the semaglutide and tirzepatide groups than the control group, with an average weight loss of more than 10% in tirzepatide users and more than 6% weight loss in semaglutide users by 9 months (Table 1b). Semaglutide users had an average 0.40% improvement in HbA1c, and tirzepatide users had an average 0.67% improvement in HbA1c (Table 1b).
Conclusion: Semaglutide and tirzepatide reduced weight and improved HbA1c in adults with T1D, with greater weight loss efficacy for tirzepatide.
H. Gebre: None. J.K. Snell-Bergeon: None. V.N. Shah: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Sanofi, Medscape. Consultant; embecta, Tandem Diabetes Care, Inc.
