Glucose Control and Continuous Glucose Monitoring Metrics During 12 Months of Treatment with Tirzepatide in Overweight or Obese Patients with Type 1 Diabetes.

Mar 10, 2026Diabetes technology & therapeutics

Blood Sugar Control and Monitoring Over 12 Months of Tirzepatide Treatment in Overweight or Obese People with Type 1 Diabetes

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Abstract

Tirzepatide treatment was associated with a 50.8% achievement rate of composite continuous glucose monitoring targets in overweight or obese adults with type 1 diabetes after 12 months.

Tirzepatide-treated participants showed improved time in range (TIR) at multiple time points: +4.6% at 3 months, +9.0% at 6 months, +6.9% at 9 months, and +7.4% at 12 months compared to controls.
Time in tight range (TITR) was significantly higher in the tirzepatide group at 6, 9, and 12 months.
Mean glucose levels, time above range (TAR), and time >250 mg/dL were lower in the tirzepatide group compared to controls.
Time below range <70 mg/dL and <54 mg/dL remained similar between tirzepatide and control groups throughout the study.
No severe hypoglycemia or diabetic ketoacidosis occurred in either treatment group.

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OBJECTIVE: A majority of adults with type 1 diabetes (T1D) are overweight (OW) or obese (OB) and often struggle to reach glycemic targets. Tirzepatide, a dual-incretin approved for type 2 diabetes (T2D) and OW/OB, has been shown to improve glucose control, reduce body weight, and insulin requirements in off-label adjunctive use for patients with T1D. This study evaluated changes in continuous glucose monitoring (CGM) data over 12-months of tirzepatide use in OW/OB adults with T1D.

MATERIALS AND METHODS: This a single-center, retrospective, longitudinal case-control study included 61 OW/OB adults with T1D using tirzepatide and 54 computer-matched (for age, HbA1c, and weight) controls. CGM data were analyzed at baseline and every 3 months over a 15-month period (-3, 3, 6, 9, and 12 months). We assessed both within- and between-groups changes in CGM metrics from baseline at each time point.

RESULTS: Baseline characteristics were similar between tirzepatide-treated and control groups for age, HbA1c, and body weight. Compared with controls, tirzepatide-treated group significantly improved CGM metrics over 12 months. Time in range (TIR) was higher at 3 months (+4.6%,= 0.04) and remained greater at 6 (+9.0%,< 0.001), 9 (+6.9%,< 0.001), and 12 months (+7.4%,< 0.001). Time in tight range (TITR) was also higher at 6-12 months (≤ 0.02). Mean glucose, time above range (TAR), time >250 mg/dL, and coefficient of variation were all lower in the tirzepatide group compared with controls. Time below range <70 mg/dL (TBR) and TBR2 (<54 mg/dL) remained similar between groups throughout the study. At 12 months, a greater proportion of tirzepatide-treated participants achieved composite CGM targets (TIR ≥70% and TBR <4%) compared with controls (50.8% vs. 25.9%;< 0.01). No severe hypoglycemia or diabetic ketoacidosis occurred in either group. P P P P P P

CONCLUSIONS: We conclude that adjunctive tirzepatide treatment in OW/OB adults with T1D was associated with sustained improvements in CGM metrics over 12 months, without increased hypoglycemia risk in this real-world study. Proper long-term randomized control trials are needed to confirm our findings.

Glucose Control and Continuous Glucose Monitoring Metrics During 12 Months of Treatment with Tirzepatide in Overweight or Obese Patients with Type 1 Diabetes.

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