What is it about?
This observational pilot study (n=4; mean age 79.5 years) tracked continuous glucose monitoring (CGM) around the first injection of tirzepatide in older Japanese adults with type 2 diabetes. Researchers compared CGM metrics before vs. after initiation and noted changes in medication burden.
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Why is it important?
Fast CGM improvements: Time in Range (70–180 mg/dL) rose from 53.2% → 78.9% (p=0.041). Time Above Range fell from 45.8% → 19.7% (p=0.038). Time Below Range changed 1.0% → 1.5% (NS). Simpler regimens: Two patients reduced oral agents; two reduced insulin injection frequency soon after starting tirzepatide. Geriatric relevance: Better hyperglycemia control without an immediate rise in hypoglycemia can help Category II patients (mild cognitive/IADL issues) manage diabetes more safely.
Perspectives
Clinical takeaway: Tirzepatide can rapidly improve CGM metrics and may enable deprescribing (fewer pills/insulin shots) in older adults. Monitor risks: Weight loss was brisk; one patient stopped therapy due to excess loss—important given frailty/sarcopenia risk in older, often non-obese Asian patients. Kidney function: Short-term eGFR dips occurred in some cases—consistent with early “initial dip”; monitor closely. Use prudently: Start low, reassess frequently (symptoms, weight, CGM, eGFR), and tailor by functional category and nutrition status. Research next steps: Larger, longer studies in older and non-obese populations to define durability, safety, optimal dosing, and effects on function and tolerability.
Prof Takuya Omura
National Center for Geriatrics and Gerontology
Read the Original
This page is a summary of: Tirzepatide and Glycemic Control Metrics Using Continuous Glucose Monitoring in Older Patients with Type 2 Diabetes Mellitus: An Observational Pilot Study, Geriatrics, February 2024, MDPI AG,
DOI: 10.3390/geriatrics9020027.
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