Real‐World Effectiveness and Safety of Tirzepatide in Type 1 Diabetes and Obesity: Impact on Glycaemia, Weight, and Cardiometabolic Risk Markers
Main finding · Change in HbA1cResult — go to the resultMean reduction 6.5 mmol/mol 95% CI 3.8–9.1Authors' conclusion
In a real-world setting, tirzepatide significantly improves glycaemia, weight, and markers of cardiometabolic risk in people with type 1 diabetes and obesity with a reassuring safety profile.
Study context
- Population
- Adults with T1D and obesity (BMI ≥ 30 kg/m²); mean age 42.8 years, BMI 37.4 kg/m², HbA1c 64.3 mmol/mol, 32% male
- Participants
- 142 vs 50
- Exposure
- Tirzepatide vs matched controls
- Tirzepatiden = 142
- Controlsn = 50reference
- Outcome
- Change in HbA1c
- Follow-up
- 12 months
Methodological detailsreal-world, age-, sex- and BMI-matched controls, Median follow-up 365 days; median tirzepatide dose (72.4%) 5 mg weekly
- Real-world
- Age-, sex- and BMI-matched controls
- Median follow-up 365 days; median tirzepatide dose (72.4%) 5 mg weekly
Main finding
As reported in the abstract
Mean reduction
6.5 mmol/mol
95% CI 3.8–9.1
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Weight · 12 months | mean reduction 13.4 kg (CI 11.0–15.8) | P < 0.001 |
| Total daily insulin dose · 12 months | mean reduction 29.9 units (CI 16.9–42.9) | P < 0.001 |
| Cardiometabolic markers (improvement vs controls)Tirzepatide vs Controls | systolic BP improvement 12.6 mmHg | P < 0.001 |
| Cardiometabolic markers (improvement vs controls)Tirzepatide vs Controls | diastolic BP improvement 4.1 mmHg | P = 0.034 |
| Cardiometabolic markers (improvement vs controls)Tirzepatide vs Controls | total cholesterol improvement 0.8 mmol/L | P < 0.001 |
| Cardiometabolic markers (improvement vs controls)Tirzepatide vs Controls | non-HDL cholesterol improvement 0.6 mmol/L | P < 0.001 |
| Cardiometabolic markers (improvement vs controls)Tirzepatide vs Controls | TG improvement 0.7 mmol/L | P < 0.001 |
Safety
Safety and persistence · 1 year
- Continued on tirzepatide at 1 year
- 89.4%
- Side effects were common
- No between-group difference in severe hypoglycaemia, ketoacidosis nor hospitalisation rates
Original publication
Real‐World Effectiveness and Safety of Tirzepatide in Type 1 Diabetes and Obesity: Impact on Glycaemia, Weight, and Cardiometabolic Risk Markers. Diabetes Obes Metab. Published 6 July 2026. doi:10.
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