1293-OR: Changes in Diabetic Retinopathy (DR) in People with Type 1 Diabetes Using Tirzepatide for >1 Year

Introduction and Objective: Use of dual glucagon-like-peptide-1/glucose-dependent insulinotropic polypeptide receptor-agonists is increasing in overweight/obese (OW/OB) individuals with T1D. Their effects on DR in individuals with T1D are unknown. Methods: Retrospective chart review of OW/OB individuals with T1D at the Barbara Davis Center for Diabetes. Individuals who used tirzepatide for 12 ± 2 months (cases) were matched by sex, age ± 4 years, and BMI ± 1.5 kg/m2 (controls). Individuals with retinal examinations at baseline and on follow-up (6-24 months) were included. DR incidence rates were calculated for those without baseline DR. For people with baseline DR, DR progression and regression were evaluated. Results: Baseline characteristics were similar for 106 cases and 85 controls, except for BMI, which was higher among cases (Table). HbA1c improved within 6 months and remained lower for cases, but was unchanged for controls. Among 39 cases and 24 controls without baseline DR, 10 (25.6%) cases and 7 (29.2%) controls developed DR on follow-up (p=0.78). Among 39 cases, DR developed in 7 (17.9%) individuals with an HbA1c decline of ≥0.5% within 6 months compared to 3 (7.7%) without it (p=0.18). Most individuals with preexisting DR had stable or regressed DR on follow-up (cases and controls; Table). Conclusion: Off-label use of tirzepatide in OW/OB subjects with T1D improved BMI and HbA1c without increasing incidence or progression of DR compared to controls. Disclosure S. Polsky: Research Support; Current; Leona M. and Harry B. Helmsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases, JDRF, University of Colorado. Other - honoraria for speaking engagements; Current; Children's Diabetes Foundation. Other - honororia for speaking engagements; Current; American Diabetes Association. Board Member; Current; American College of Diabetology. Other - unpaid work to write articles for online publication; Ended; diaTribe. Research Support; Ended; Dexcom, Inc. Other - travel and lodging expenses paid for a meeting; Ended; Insulet Corporation. Other - honororia for speaking engagements; Current; AACE. E. Beck: Other - Contract pump trainer; Current; Tandem Diabetes Care, Inc. D. Cengiz: None. A. Shah: None. E. Nease: None. S. Garg: Advisory Panel; Current; Abbott Diabetes. Research Support; Current; Eli Lilly and Company. Advisory Panel; Current; Medtronic. Research Support; Current; Dexcom, Inc. Advisory Panel; Current; Roche Diagnostics, Vertex Pharmaceuticals Incorporated, ConvaTec Inc. Research Support; Current; Diasome.