Abstract：
The purpose of this case report is to describe the use of tirzepatide, a glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonist, in a patient with type 1 diabetes mellitus (T1DM) and obesity.
A 23-year-old female with T1DM since the age of 10 years was referred to an endocrinology clinic for specialized diabetes care with a pharmacist owing to increasing insulin requirements and resistance. At baseline, the patient weighed 195 pounds (86.64 kg), which had increased significantly by approximately 40 pounds in the last year, and had a body mass index of 38 kg/m2 and hemoglobin A1c (HbA1c) level of 7.4%. She used hybrid closed loop insulin pump technology with continuous glucose monitoring in 100% automation mode. The patient used on average 55.4 units of basal insulin and 26.5 units of bolus per day (total daily dose, 81.9 units) with a time in range (TIR) of 31%. The patient was started on tirzepatide 2.5 mg weekly and titrated to 7.5 mg weekly with 4-week dose titrations. After 12 weeks, the patient\'s TIR had doubled to 61% with improvements in glucose variability, insulin requirements had decreased to 57.6 units per day, HbA1c had decreased to 6.9%, daily carbohydrates had decreased by approximately 24%, and weight had decreased to 188 pounds (-7 lbs).
With additional studies, tirzepatide may be a safe and effective option for patients with T1DM and obesity to improve glycemic control, reduce insulin requirements, and promote weight loss.
A 23-year-old female with T1DM since the age of 10 years was referred to an endocrinology clinic for specialized diabetes care with a pharmacist owing to increasing insulin requirements and resistance. At baseline, the patient weighed 195 pounds (86.64 kg), which had increased significantly by approximately 40 pounds in the last year, and had a body mass index of 38 kg/m2 and hemoglobin A1c (HbA1c) level of 7.4%. She used hybrid closed loop insulin pump technology with continuous glucose monitoring in 100% automation mode. The patient used on average 55.4 units of basal insulin and 26.5 units of bolus per day (total daily dose, 81.9 units) with a time in range (TIR) of 31%. The patient was started on tirzepatide 2.5 mg weekly and titrated to 7.5 mg weekly with 4-week dose titrations. After 12 weeks, the patient\'s TIR had doubled to 61% with improvements in glucose variability, insulin requirements had decreased to 57.6 units per day, HbA1c had decreased to 6.9%, daily carbohydrates had decreased by approximately 24%, and weight had decreased to 188 pounds (-7 lbs).
With additional studies, tirzepatide may be a safe and effective option for patients with T1DM and obesity to improve glycemic control, reduce insulin requirements, and promote weight loss.
摘要：
目的：本病例报告的目的是描述替瑞哌肽的使用，葡萄糖依赖性促胰岛素多肽/胰高血糖素样肽-1（GIP/GLP-1）受体激动剂，1型糖尿病（T1DM）和肥胖患者。
方法：一名23岁女性从10岁开始患有T1DM，由于胰岛素需求和抵抗的增加，他被转诊到内分泌科诊所接受专业糖尿病护理，由药剂师进行。在基线,病人重195磅(86.64公斤)，去年大幅增加了约40磅，BMI为38kg/m2，HbA1c水平为7.4％。她以100％自动化模式使用连续葡萄糖监测（CGM），平均每天使用55.4单位的基础胰岛素和26.5单位的推注（每日总剂量：81.9单位），时间范围（TIR）为31％。患者开始每周服用2.5mg的替利西帕肽，并以4周的剂量滴定每周至7.5mg。12周后,随着血糖变异性的改善，患者的TIR增加了一倍，达到61%，胰岛素需求下降到每天57.6个单位，HbA1c已降至6.9%，每日碳水化合物减少了约24%，体重下降到188磅。
结论：通过其他研究，替瑞哌肽可能是T1DM和肥胖患者改善血糖控制的安全有效选择,减少胰岛素需求，促进减肥。
方法：一名23岁女性从10岁开始患有T1DM，由于胰岛素需求和抵抗的增加，他被转诊到内分泌科诊所接受专业糖尿病护理，由药剂师进行。在基线,病人重195磅(86.64公斤)，去年大幅增加了约40磅，BMI为38kg/m2，HbA1c水平为7.4％。她以100％自动化模式使用连续葡萄糖监测（CGM），平均每天使用55.4单位的基础胰岛素和26.5单位的推注（每日总剂量：81.9单位），时间范围（TIR）为31％。患者开始每周服用2.5mg的替利西帕肽，并以4周的剂量滴定每周至7.5mg。12周后,随着血糖变异性的改善，患者的TIR增加了一倍，达到61%，胰岛素需求下降到每天57.6个单位，HbA1c已降至6.9%，每日碳水化合物减少了约24%，体重下降到188磅。
结论：通过其他研究，替瑞哌肽可能是T1DM和肥胖患者改善血糖控制的安全有效选择,减少胰岛素需求，促进减肥。
