7431 Non-Insulin Treatment of Type 1 Diabetes Mellitus: The Power of GLP-1 and GLP-1/GIP RA

Abstract Disclosure: J. Ferri-Guerra: None. E. Kasper-Guerra: None. O. Abdulhussein: None. G. Madrigal Loria: None. J. Ambalavanan: None. K. Zhou: None. Background: Insulin is the mainstay of treatment of patients with type 1 diabetes mellitus (T1D). However, patients with T1D can also potentially benefit from adjunctive therapies such as GLP-1 receptor agonists or GLP-1/GIP receptor agonists, especially when obesity and elevated cardiovascular risk are present. Case 1: A 64-year-old male with severe coronary artery disease requiring revascularization and obesity with T1D has been wearing a pump for insulin delivery since the age of 43, started on closed loop system Control IQ with Tandem in April 2022. In December 2022, patient had myocardial infarction. At that time, Hba1c was elevated at 7.6% and BMI was elevated at 32.5 kg/m2, and patient was considered a good candidate for tirzepatide, which was prescribed. The tirzepatide dose was slowly increased, up to 10 mg weekly. The new therapy resulted in loss of 17 kg (20.1% decrease of body weight) with only some mild nausea. There was an improvement in HbA1c to 7.1% and a dramatic reduction in daily average insulin use from 90 units to 52 units. Case 2: A 59-year-old female with obesity and T1D diagnosed at the age of 8 had been wearing insulin pump, Medtronic 670G in manual mode, for insulin delivery for the past few years with poor glycemic control. In August 2021, patient was prescribed semaglutide for post prandial hyperglycemia and obesity management (BMI at 31.6kg/m2). Since being on the medication, she lost 12kg (16.8% decrease in body weight), despite being on the lowest dose of 0.25 mg (maximum tolerated). Her HbA1c has improved from 8.2% when therapy was initiated, to 7% with just the introduction of semaglutide to her insulin regimen. Conclusion: Although insulin is a required therapy for patients with T1D, adjunctive therapies may improve glycemic control, reduce insulin requirements and promote weight loss. GLP-1 and dual GLP-1/GIP receptor agonists should be considered for these patients. Presentation: 6/1/2024