Diabetology
Semaglutide and Tirzepatide in Type 1 Diabetes: Real-World Insulin-Dose Reduction, Metabolic Outcomes and Safety Assessment
By Robert P. Matson, Karthik Murugadoss, AJ Venkatakrishnan and 1 others.
Abstract
Background
Semaglutide and tirzepatide are not approved for type 1 diabetes (T1D), and their real-world effects on insulin requirements, metabolic outcomes, and safety are uncertain.
Methods
Using de-identified electronic health record data from a federated U.S. network (2018–2025), adults with T1D who initiated semaglutide (n = 1447) or tirzepatide (n = 568) were matched 1:1 to unexposed adults with T1D on demographics, comorbidities, glycated hemoglobin (HbA1c), body mass index (BMI), estimated glomerular filtration rate (eGFR), T1D duration, healthcare utilization, and calendar year (Cohort A). Insulin total daily dose (TDD) was analyzed in a second cohort additionally matched on baseline TDD and insulin delivery modality (Cohort B; 337 semaglutide and 117 tirzepatide pairs).
