Effect of Tirzepatide on Body Weight and Diabetes Control in Adults With Type 1 Diabetes and Overweight or Obesity
Abstract
Objective To determine the effect of tirzepatide on weight, diabetes control, and insulin requirements, and its safety profile in adults with type 1 diabetes (T1D) and overweight or obesity. Patients and methods This is a retrospective study of adults with T1D using tirzepatide for overweight/obesity treatment between June 1, 2022, and October 31, 2023, at Mayo Clinic. Fifty-one patients fulfilled inclusion and exclusion criteria (adults with established T1D diagnosis and a body mass index ≥27 kg/m 2 using tirzepatide for 3 months or longer and without a history of bariatric surgery or active malignancy). Data were collected from the electronic medical record and reported as median (Q1-Q3). Results Most individuals were female (30, 58.8%), White (49, 96.1%), and with obesity class III (21, 41.2%). During a median follow-up time of 8.0 (Q1-Q3: 4.0-10.0) months, the total body weight loss was 8.5% (Q1-Q3: 5.3%-13.8%) (P<.01). At 12 months, total body weight loss was 12.2% (Q1-Q3: 7.3%-19.8%) (n=26). By the last follow-up, hemoglobin A 1c decreased by 0.9% (Q1-Q3: 0.3%-1.1%) (P<.0001) and daily insulin requirements by 31.6% (Q1-Q3: -48.0% to -10.9% (P<.01). Basal and bolus insulin doses decreased proportionally, with a more precipitous decline during the first 6 months of tirzepatide therapy. The use of tirzepatide was associated with an improvement of cardiometabolic parameters. There was no increased incidence of hypoglycemia. The most common side effect was nausea (7, 13.7%). Conclusion Tirzepatide for the treatment of overweight and obesity in adults with T1D leads to substantial weight loss, improved diabetes control, and decreased insulin requirements, without worsening hypoglycemia. Future studies are needed to ascertain the long-term effect of tirzepatide in this population, ideally focusing on cardiovascular outcomes.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a retrospective study of 51 people with type 1 diabetes and obesity, tirzepatide was associated with a mean weight loss of 8.5% over 8 months.
“In a retrospective study of 51 T1D people with obesity, tirzepatide was associated with 8.5% mean Weight loss, 0.9% HbA1c reduction, and a 31.6% decrease in daily insulin dose over 8 months, with no increase in hypoglycemia; GI symptoms were the main side effect; overall tolerability was high [52].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [52]
In the same retrospective study of 51 people with type 1 diabetes and obesity, tirzepatide was associated with a 31.6% decrease in daily insulin dose over 8 months.
“In a retrospective study of 51 T1D people with obesity, tirzepatide was associated with 8.5% mean Weight loss, 0.9% HbA1c reduction, and a 31.6% decrease in daily insulin dose over 8 months, with no increase in hypoglycemia; GI symptoms were the main side effect; overall tolerability was high [52].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [52]
In the same retrospective study of 51 people with type 1 diabetes and obesity, tirzepatide was associated with a 0.9% HbA1c reduction over 8 months.
“In a retrospective study of 51 T1D people with obesity, tirzepatide was associated with 8.5% mean Weight loss, 0.9% HbA1c reduction, and a 31.6% decrease in daily insulin dose over 8 months, with no increase in hypoglycemia; GI symptoms were the main side effect; overall tolerability was high [52].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [52]
Cites
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629 · see citing works
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
Marso, S. P., Bain, S. C., Consoli, A., Eliaschewitz, F. G., Jódar, E., Leiter, L. A., Lingvay, I., Rosenstock, J., Seufert, J., Warren, M. L., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1607141 · Cited by 6,900 · see citing works
Tirzepatide Once Weekly for the Treatment of Obesity
Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2206038 · Cited by 3,838 · see citing works
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
Lincoff, A. M., Brown-Frandsen, K., Colhoun, H. M., Deanfield, J., Emerson, S. S., Esbjerg, S., Hardt-Lindberg, S., Hovingh, G. K., Kahn, S. E., Kushner, R. F., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2307563 · Cited by 3,236 · see citing works
Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes
Frías, J. P., Davies, M. J., Rosenstock, J., Pérez Manghi, F. C., Fernández Landó, L., Bergman, B. K., Liu, B., Cui, X., & Brown, K. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2107519 · Cited by 2,096 · see citing works
Gregory, G. A., Robinson, T. I. G., Linklater, S. E., Wang, F., Colagiuri, S., de Beaufort, C., Donaghue, K. C., Harding, J. L., Wander, P. L., Zhang, X., et al. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00218-2 · Cited by 1,149 · see citing works
Dahl, D., Onishi, Y., Norwood, P., Huh, R., Bray, R., Patel, H., & Rodríguez, Á. (2022) · JAMA · doi:10.1001/jama.2022.0078 · Cited by 597 · see citing works
Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022.
Watanabe, J. H., Kwon, J., Nan, B., & Reikes, A. (2024) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2023.10.002 · Cited by 216 · see citing works
Davies, M. J., Aronne, L. J., Caterson, I. D., Thomsen, A. B., Jacobsen, P. B., Marso, S. P., & groups, O. B. O. T. S. A. C. A. –. L. E. I. I. W. A. W. D. (. S. (2018) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.13125 · Cited by 115 · see citing works
Prevalence and Management of Obesity in U.S. Adults With Type 1 Diabetes
Fang, M., Jeon, Y., Echouffo-Tcheugui, J. B., & Selvin, E. (2023) · Annals of Internal Medicine · doi:10.7326/m22-3078 · Cited by 81 · see citing works
Park, J., Ntelis, S., Yunasan, E., Downton, K. D., Yip, T. C.-F., Munir, K. M., & Haq, N. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad471 · Cited by 69 · see citing works
Efficacy and Safety of Tirzepatide in Overweight and Obese Adult Patients with Type 1 Diabetes
Garg, S. K., Akturk, H. K., Kaur, G., Beatson, C., & Snell-Bergeon, J. (2024) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2024.0050 · Cited by 65 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Tuccinardi, D., Masi, D., Watanabe, M., Zanghi Buffi, V., De Domenico, F., Berti, S., Cipriani, V., Manco, M., Manfrini, S., & Pagotto, U. (2025) · Journal of Endocrinological Investigation · doi:10.1007/s40618-025-02700-7 · Cited by 29 · see citing works
- Authors
- Rivera Gutierrez, R., Tama, E., Bechenati, D., Castañeda Hernandez, R., Bennett, P. K., McNally, A. W., Fansa, S., Anazco, D., Acosta, A., & Hurtado Andrade, M. D.
- Affiliations
- Mayo Clinic (US)
- Mayo Clinic in Florida (US)
- ORCID
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2025-02
- Volume
- 100
- Issue
- 2
- Pages
- 265-275
- ISSN
- 0025-6196 (ISSN-L)
- OpenAlex
- W4404733968
- Cited by
- 31
- References
- 12
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 1
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (K12-AR084222)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- tirzepatide, type 1 diabetes, obesity, overweight, weight loss, glycemic control, HbA1c, insulin requirement, GLP-1 receptor agonists, hypoglycemia, nausea, cardiometabolic parameters, drug safety, insulin dose reduction
- MeSH terms
- Tirzepatide, Adult, Body Weight, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Obesity, Retrospective Studies, Weight Loss, Body Mass Index, Treatment Outcome, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
