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Journal Article Observational Study Ppublish 2 citations

PubMed: 42555627 DOI: 10.1002/dmrr.70213

Weight Loss-Dependent Changes in Body Composition and Bone Health in People With Obesity and Type 1 Diabetes Treated With Liraglutide, Semaglutide, or Tirzepatide.

Diabetes Metab Res Rev 42(6):e70213

Authors: Ebaa Al Ozairi, Mohammad Irshad, Jumana Alkandri, Anant Mashankar, Stuart R Gray, Carel W le Roux

Affiliations

  • DAFNE Unit, Clinical Care Research and Trials Unit, Dasman Diabetes Institute, Kuwait City, Kuwait.
  • DAFNE Unit, Clinical Care Research and Trials Unit, Dasman Diabetes Institute, Kuwait City, Kuwait. Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
  • Diagnostic Imaging Center, Dasman Diabetes Institute, Kuwait City, Kuwait.
  • School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
  • Diabetes Complications Research Centre, University College Dublin, Dublin, UK.
  • School of Medicine, Ulster University, Coleraine, UK.

Abstract

AIMS

This study examined changes in body composition and bone mineral density (BMD) over 12 months in people with obesity and type 1 diabetes (T1D) treated with a GLP-1 receptor agonist alone (GLP-1RA) or a dual glucose-dependent insulinotropic polypeptide (GIP/GLP-1RA).

MATERIALS AND METHODS

This real-world observational study included 70 people with obesity and T1D treated with GLP-1RA alone or dual GIP/GLP-1RA. Dual-energy X-ray absorptiometry (DEXA) was used to quantify regional and total fat mass, lean mass, bone mineral content (BMC) and BMD at baseline and after 12 months of treatment. Overall changes were quantified, and changes stratified by percentage weight loss using repeated measures analysis.

RESULTS

Over 12 months body weight (-6.33%; 95% CI: -7.92, -4.73; p < 0.001), HbA1c (-0.48%; 95% CI: -0.74, -0.22; p < 0.001), total tissue fat (-1.42%; 95% CI: -2.47, -0.36; p = 0.009), fat mass (-5.90%; 95% CI: -10.50, -1.57; p = 0.001), and lean mass (-1.75%; 95% CI: -3.50, -0.48; p = 0.005) decreased, while total BMC and BMD remained unchanged. Total lean mass loss was associated with body weight loss (R 2 = 0.36, p < 0.001).

CONCLUSIONS

In people with obesity and T1D, 12-month GLP-1RA alone or dual GIP/GLP-1RA therapy resulted in clinically meaningful weight loss, improved glycaemic control, preferential fat mass reduction, modest lean mass loss, and preservation of total BMD. People achieving > 10% weight loss derived the greatest metabolic benefit without compromising bone health, although the loss of lean mass was greater.

MeSH

Diabetes Mellitus, Body Composition, Liraglutide, Body Weight, Obesity, Weight Loss, Therapeutics, Diabetes Mellitus, Type 1, Semaglutide