748-P: Tirzepatide Adjunctive Therapy in Adults with Type 1 Diabetes Using Tandem Control-IQ

Objective: Safety and efficacy of adjunct therapy with Tirzepatide, a dual agonist, in adults with type 1 diabetes (T1D) using Tandem Control-IQ automated insulin delivery system is unknown. This study investigates changes in insulin requirements and glycemic outcomes in adults with T1D over 8 months of Tirzepatide treatment. Methods: In this single-center, observational study, we collected demographic, A1c, weight (from electronic medical records), sensor glucose and insulin dose (from t:connect) for adults with T1D who were using Tandem Control-IQ and initiated Tirzepatide adjunct therapy for clinical indications (n=11, median age 36.2, 64% female and mean BMI of 38.6 kg/m2). Data were compared from baseline and over 8 months. Results: The insulin requirements (total, basal and bolus insulin per day) were reduced significantly within 2 months (p<0.01 for all) of Tirzepatide therapy (2.5-5 mg/week), and thereafter, there was no clinically meaningful reduction in insulin dose (Figure 1-A). The frequency of user-initiated boluses did not differ throughout the study. Despite significant reduction in insulin dose, A1c (-0.46%), weight (mean weight reduction -10 kg) and significant improvement in time in range, there was no increase in time below 70 mg/dL (Figure 1-B). Conclusion: Tirzepatide adjunct to Tandem Control-IQ improved glycemic and metabolic outcomes without increasing hypoglycemia. Disclosure K.E. Karakus: None. M.P. Klein: None. H.K. Akturk: Consultant; Medtronic. Research Support; Medtronic. Consultant; Dexcom, Inc. Research Support; MannKind Corporation, Tandem Diabetes Care, Inc. Consultant; Tandem Diabetes Care, Inc. 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.