bluuebunny/crossref_metadata_2025_split huggingface dataset:
708-P: Association of Hypoglycemia Problem-Solving Abilities with Severe Hypoglycemia in Adults with Type 1 Diabetes—A Poisson Regression Analysis
Authors: SAKANE SEIKO , SAKANE NAOKI 
Published: June 2024

Background: Severe hypoglycemia (SH) poses a significant challenge in the management of type 1 diabetes (T1D); however, the factors that offer protection other than diabetes technologies are under-studied. The primary objective of this study was to examine the association between hypoglycemia problem-solving (HPS) abilities and severe hypoglycemic events in adults with T1D using Poisson regression analysis.
Methods: In this cross-sectional study, 287 adults with T1D (mean age: 50.3 ± 14.5 years, male: 36.2%, diabetes duration: 17.5 ± 11.2 years, mean HbA1c: 7.7 ± 0.9%) were included and categorized into two groups: non-SH (n = 262) and SH (n = 25). Data on diabetic complications, the hypoglycemia problem-solving scale (HPSS), and treatment details were collected. Impaired awareness of hypoglycemia (IAH) was evaluated using Gold's method. Univariate and multivariable Poisson regression models were used for the analysis, and the findings were presented as incidence rate ratios (IRRs) at 95% confidence intervals (CIs).
Results: The incidence of SH was 16.7 (95% CI: 7.5-26.0) per 100 person-years. Univariate Poisson regression analysis associated IAH, diabetic peripheral neuropathy (DPN), problem-solving perception score of HPSS (HPSS1), real-time continuous glucose monitoring use, continuous subcutaneous insulin infusion usage with SH, whereas multivariate Poisson regression analysis significantly associated the HPSS 1 score (IRR: 0.51, 95% CI: 0.34, 0.76; P = 0.001) and DPN (IRR: 4.65, 95% CI: 1.96-11.04; P &lt; 0.001) with SH.
Conclusion: We identified HPS abilities, in addition to DPN, were associated with SH in adults with T1D.

Disclosure
S. Sakane: None. N. Sakane: None.
719-P: Metabolomic Characteristics Associated with Changes in Fasting Blood Glucose in a 12-Month Lifestyle Intervention Trial
Authors: LEWIS KIMBERLY A. , STROEBEL BENJAMIN M. , ZHANG LI , KANAYA ALKA M. , FLOWERS ELENA 
Published: June 2024

Introduction & Objective: Lifestyle interventions are effective type 2 diabetes (T2D) prevention strategies, yet little is known about metabolic pathways associated with intervention response in at-risk individuals. The study's purpose was to characterize the baseline metabolome in adults at risk for T2D who responded to a 12-month lifestyle intervention randomized controlled trial with significantly reduced fasting blood glucose (FBG).
Methods: This study analyzed de novo untargeted primary metabolome data from 113 plasma samples stored in a biorepository. The parent study recruited participants from San Diego and San Francisco communities between 2009-2012. Data were acquired via the West Coast Metabolomics Core Laboratory using validated liquid chromatography mass spectrometry methods and 15-25 internal standards. Metabolites were quantified by peak heights. Relative concentrations were compared between lifestyle intervention responders and non-responders using independent t-tests and then adjusted for multiple comparisons.
Results: Six metabolites were significantly different (unadj p&lt;0.05) between the group of responders and non-responders (pelargonic acid, oleic acid, lysine, hypoxanthine, heptanoic acid, 3-hydroxybutyric acid).
Conclusions: At-risk adults in our sample who responded to a lifestyle intervention with significantly decreased FBG exhibited baseline differences in primary metabolism compared with those that did not respond. Findings align with our previously work in this sample characterizing the gene targets and microRNAs, which implicated novel pathways of neurodegenerative and protein misfolding disorders, as well as immune function and inflammation pathways known to be associated with T2D. Findings may help to refine target biological pathways for prevention therapies or define a subtype of participants who are best suited for lifestyle interventions to manage T2D risk.

Disclosure
K.A. Lewis: None. B.M. Stroebel: None. L. Zhang: None. A.M. Kanaya: None. E. Flowers: None.

Funding
Larry L. Hillblom Foundation (2022-D-011-FEL)
733-P: Efficacy and Safety of HS-20094 in Patients with Type 2 Diabetes—A Randomized, Double-Blind, Placebo-Controlled, Phase 2 Trial
Authors: LIU LIN , SHI XIAOXIA , HE FEI , CHENG ZHIFENG , SONG WEIHONG , WANG ZHONGJING , CUI YIMIN , ZHANG JUNQING 
Published: June 2024

Introduction and Objective: HS-20094 is a novel dual GIP and GLP-1 receptor agonist. A 4-week POC study was conducted to assess the preliminary efficacy and safety of HS-20094 in patients with type 2 diabetes (T2DM).
Methods: This was a randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov number, NCT06118008). Patients with T2DM poorly controlled with diet and exercise alone or with stable metformin (HbA1c ≥7.0 to ≤10.0%) were randomly (4:1:1) assigned within each cohort to receive HS-20094 (5mg, 10mg or 15mg), semaglutide (1.0mg), or placebo subcutaneously once-weekly. The primary outcome was the change in HbA1c from baseline to week 4. Efficacy results between groups were compared using analysis of covariance (ANCOVA) with baseline value as a covariate and status of metformin use as a fixed effect.
Results: Totally, 54 subjects received at least one dose of HS-20094, semaglutide or placebo. Least square mean (LSM) change in HbA1c was -0.63%, -0.75%, -0.84%, and -0.59% in HS-20094 of 5mg, 10mg, 15mg and semaglutide, respectively (all p&lt;0.01 vs placebo). LSM change in fasting blood glucose in corresponding cohort was -2.87, -2.25, -2.79, and -1.92mmol/L, respectively (all p&lt;0.01 vs placebo). LSM percent change in body weight was -1.27%, -2.51%, -4.41%, and -1.35%, respectively (p = 0.192, p= 0.016, p&lt;0.001, and p = 0.179 vs placebo). The occurrence of adverse events (AEs) was not dose-dependent in HS-20094. The most common AE included decreased appetite, abdominal distension and vomiting. No severe hypoglycemia was reported.
Conclusion: In patients with T2DM, HS-20094 was generally safe and showed meaningful HbA1c, fasting blood glucose and body weight reductions.

Disclosure
L. Liu: None. X. Shi: None. F. He: None. Z. Cheng: None. W. Song: None. Z. Wang: None. Y. Cui: None. J. Zhang: None.
737-P: Acute Healthcare Utilization, Mortality, and Cardiovascular Events following GLP-1-RA Initiation by Patients with Advanced Chronic Kidney Disease—A Real-World Comparative Study
Authors: ZHANG SHUYAO , SIDRA FNU , ALVAREZ CARLOS A. , KINAAN MUSTAFA , LINGVAY ILDIKO , MANSI ISHAK 
Published: June 2024

Introduction & Objective: Treatment with glucagon-like peptide-1 receptor agonists (GLP1-RA) in patients with type 2 diabetes and chronic kidney disease (CKD) may attenuate the progression of renal disease and cardiovascular events but their real-world impact on healthcare utilization and mortality in this population are not well-defined. This study aims to compare outcomes following initiation of GLP1-RA vs Dipeptidyl peptidase-4 inhibitors (DPP4i), as active comparators, in patients with diabetes and advanced CKD.
Methods: Retrospective cohort study using data from Veterans Health Administration during fiscal years 2006 to 2021. Inclusion criteria included U.S. veterans aged 35 years or older with advanced CKD who filled either GLP1-RA or DPP4i prescriptions. The primary outcome was acute healthcare utilization. Secondary outcomes were all-cause mortality and acute cardiovascular events (not including death).
Results: The eligible cohort included 26,997 GLP1-RA users and 37,708 DPP4 users. After propensity score matching (16,076 pairs) and 2.2 years mean follow-up duration, use of GLP1-RA was associated with lower annual rate of acute healthcare utilization (coefficient of regression β = -0.15, 95% CI -0.25 to -0.05, p=0.004) and lower all-cause mortality as compared to the DPP4i group (OR 0.84, 95% CI 0.79 to 0.89, p&lt;0.01) with time-to- death analysis showing a HR of 0.86 (95%CI: 0.82-0.90, p &lt;0.001). There was no significant difference in cardiovascular events between groups (OR 0.98, 95% CI 0.92 to 1.06, p=0.66). Conclusions: Use of GLP1-RA in patients with advanced CKD was associated with lower annual rate of acute healthcare utilization and decreased all-cause mortality. There was no significant difference in cardiovascular events between the matched groups.

Disclosure
S. Zhang: Stock/Shareholder; Eli Lilly and Company, Novo Nordisk, Amgen Inc. F. Sidra: None. C.A. Alvarez: Research Support; Boehringer-Ingelheim, Bristol-Myers Squibb Company, Merck & Co., Inc. M. Kinaan: None. I. Lingvay: Consultant; Altimmune, Astra Zeneca, Bayer, Biomea, Boehringer-Ingelheim, Carmot, Cytoki Pharma, Eli Lilly, Intercept, Janssen/J&J, Mannkind, Mediflix, Merck, Metsera, Novo Nordisk, Pharmaventures, Pfizer, Sanofi. Research Support; NovoNordisk, Sanofi, Mylan, Boehringer-Ingelheim. Consultant; TERNS Pharma, The Comm Group, Valeritas, WebMD, and Zealand Pharma. I. Mansi: None.
745-P: Effects of Liraglutide on GLP-1, GIP, and Glucagon Concentrations in Persons with Type 2 Diabetes with Multiple Daily Insulin Injections during a 24-Week Period
Authors: KOCI MARSEL , HIRSCH IRL B. , SEYED AHMADI SHILAN , LIND MARCUS 
Published: June 2024

Introduction and Objective: Although there is extensive knowledge of metabolic and cardiovascular effects of GLP-1 analogues, placebo-controlled trials are sparse examining how endogenous incretins are affected during therapy. The aim of this study was to evaluate the concentrations of GLP-1, GIP and glucagon in liraglutide treated persons with type 2 diabetes (T2D) and associations with changes in glycemic control.
Methods: The current analysis included 106 patients with available biobank samples of the 124 persons with T2D who took part in the double-blind placebo-controlled MDI liraglutide trial. Differences in GLP-1, GIP and glucagon between treatment groups were evaluated using analysis of covariance, adjusting for baseline values. Linear regression was used to evaluate baseline concentrations of GLP-1, GIP, and glucagon as possible predictors for a greater or smaller treatment effect of liraglutide on HbA1c.
Results: At 12 weeks GLP-1 was 25% lower (95% CI 9-37%, p=0.003) and GIP 39% higher (95% CI 8-79%, p=0.012) in the liraglutide group compared to the placebo group. At 24 weeks differences were sustained. Glucagon was lower in the liraglutide group at 12 weeks (p=0.052) but reached similar levels as the placebo group after 24 weeks (p=0.98). In the liraglutide group mean Hba1c decreased from 9.0% to 7.4%. Each 30% decrease in glucagon concentration at baseline was associated with 0.3% greater reduction in HbA1c at 24 weeks of treatment with liraglutide compared to placebo (95% CI 0.1-0.5%, p=0.001).
Conclusion: An essential mechanism of metabolic effects of GLP-1 analogues is potentially mediated via increased GIP levels in persons with T2D. According to our findings serum glucagon levels may be an important biomarker for GLP-1 analogue responders.

Disclosure
M. Koci: None. I.B. Hirsch: Advisory Panel; Abbott. Research Support; Dexcom, Inc. Advisory Panel; Roche Diabetes Care. Research Support; MannKind Corporation, Tandem Diabetes Care, Inc. Advisory Panel; embecta. Research Support; Tandem Diabetes Care, Inc. Advisory Panel; Vertex Pharmaceuticals Incorporated. S. Seyed Ahmadi: None. M. Lind: Consultant; AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company. Research Support; Eli Lilly and Company. Consultant; Novo Nordisk. Research Support; Novo Nordisk. Consultant; Nordic InfuCare.
755-P: GLP-1RA Therapy Recovers Vascular Regenerative Cell Content in High Cardiovascular–Risk Individuals with Type 2 Diabetes
Authors: KRISHNARAJ AISHWARYA , PARK BRADY , BAKBAK EHAB , VERMA RAJ , QUAN ADRIAN , TEOH HWEE , HESS DAVID A. , VERMA SUBODH 
Published: June 2024

Objective: GLP-1RAs are recommended as first-line therapy for cardiorenal risk reduction in people with T2D. We have shown that SGLT2 inhibitor therapy increased circulating vascular regenerative (VR) cell content in individuals with T2D. The ORIGINS-RCE trial recently reported that VR cell content was decreased in South Asian (SA) individuals compared to people of White European (WE) origin. This sub-analysis sought to determine the impact of GLP-1RA and SGLT2 inhibitor therapy on VR cell content in SA vs. WE individuals with T2D.
Methods: ORIGINS-RCE enrolled 120 individuals of SA or WE ethnicity with T2D and/or CVD. Within this cohort, 88 had T2D amongst whom 22 were on a GLP-1RA, 39 on an SGLT2 inhibitor, and 27 on neither. Multi-parametric flow cytometry was used to enumerate pro-vascular vs. pro-inflammatory progenitor cell subsets.
Results: The absolute count of VR cells (ALDHhiSSClowCD133+ cells/106 MNC) in the GLP-1RA group (310 ±56) was similar to that in the SGLT2 inhibitor group (244 ± 23; P=0.32), but greater than that in the neither therapy group (216 ± 33; P=0.027). The GLP-1RA group also had greater endothelial progenitor cell content (ALDHhiSSClowCD34+CD45-CD133+; 11 ± 3) compared to the neither therapy group (7 ± 2; P=0.011). The pro-inflammatory burden of ALDHhiSSChi precursor cells in the GLP-1RA group (41845 ± 12616) was lower than that of the neither therapy (53900 ± 7249; P=0.015). While there was no difference in ALDHhiSSClowCD133+ content between WE and SA individuals within the GLP-1RA and neither therapy groups, there were less of these cells among the SA (vs. WE) individuals in the SGLT2 inhibitor group (202 ±28 vs. 318 ± 31; P=0.010), suggesting a lack of a protective response of SGLT2 inhibitor therapy in SA people.
Conclusion: In individuals with T2D, VR progenitor cell content varied according to medication use and ethnic origin. These data uncovered conserved cardioprotective benefits of GLP-1RA therapy in high-risk SA individuals.

Disclosure
A. Krishnaraj: None. B. Park: None. E. Bakbak: None. R. Verma: None. A. Quan: None. H. Teoh: Other Relationship; Canadian Medical and Surgical Knowledge Translation Research Group. D.A. Hess: None. S. Verma: Other Relationship; Amarin Corporation, Amgen Inc., AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Canadian Medical and Surgical Knowledge Translation Research Group, Eli Lilly and Company, HLS Therapeutics Inc., Janssen Pharmaceuticals, Inc., Novartis AG, Novo Nordisk, Pfizer Inc., PhaseBio Pharmaceuticals, Inc., S&L Solutions Event Management, Sanofi.

Funding
CIHR (#369189 and #186065); Heart and Stroke Foundation (#G-23-0035127)
765-P: Efficacy and Safety of Switching to iGlarLixi from Premixed Insulin (PI) in South Korean People Living with Type 2 Diabetes (T2D)—Subanalyses of Soli-SWITCH Study
Authors: LIM SOO , HALUZIK MARTIN , YUN JAE-SEUNG , LEE JIHYUN , KIM SANGYONG , ALVAREZ AGUSTINA , LAUAND FELIPE , REN YAN , JIB YOO SOON 
Published: June 2024

Introduction & Objective: iGlarLixi is a once-daily injectable fixed-ratio combination of insulin glargine 100 U/mL + lixisenatide and may be a simplified treatment option vs PI. This sub-analysis of the Soli-SWITCH study (EudraCT number 2021-003711-25) assessed the efficacy and safety of switching to iGlarLixi in people with T2D from South Korea currently receiving once- or twice-daily PI.
Methods: In this phase 4, 24-week, single-arm study, participants switched from PI to iGlarLixi at baseline. Key inclusion criteria: participants aged ≥18 years diagnosed with T2D ≥6 months before the screening visit; had received PI for ≥3 months and &lt;10 years ± oral antidiabetic drugs, with stable doses for 3 months. Participants who experienced severe hypoglycemia within &lt;6 months prior to screening were excluded. The primary endpoint was change in HbA1c from baseline to Week 24. Secondary endpoints included the proportion of participants achieving HbA1c &lt;7% at Week 24 and safety.
Results: From 162 participants, 62 (38.3%) evaluable participants were from South Korea and received iGlarLixi. At baseline, mean HbA1c was 8.6%, standard deviation (SD) ± 0.7%. By Week 12, mean HbA1c had decreased by 1.4% (SD ± 0.8; 95% confidence interval [CI]: -1.5, -1.2). At Week 24, mean HbA1c was reduced from baseline by 1.3% (SD ± 1.0; 95% CI: -1.6, -1.1); similarly, in the total population, mean HbA1c reduced from baseline to Week 24 by 1.2% (SD ± 0.9%; 95% CI: -1.4, -1.1). In the overall population, confirmed symptomatic hypoglycemia occurred in 38.3% of total participants (ADA level 1: 35.8%; ADA level 2: 15.4%; ADA level 3: 0.0%). No new safety signals were observed.
Conclusion: In this sub-analysis of Soli-SWITCH, iGlarLixi demonstrated improved glycemic outcomes in South Korean participants living with T2D switching from PI, and may represent a simplified and efficacious treatment option vs PI in people of Asian ethnicity.

Disclosure
S. Lim: None. M. Haluzik: Advisory Panel; Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Johnson & Johnson Medical Devices Companies. Consultant; Merck & Co., Inc., Sanofi, Novo Nordisk, Eli Lilly and Company, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Johnson & Johnson Medical Devices Companies, Novatin. Research Support; Sanofi. Speaker's Bureau; Sanofi, Novo Nordisk. J. Yun: None. J. Lee: None. S. Kim: Research Support; Sanofi, Novo Nordisk, Boryung, Hanmi Pharm. Co., Ltd., Handok, Deawoong. Speaker's Bureau; Boryung, Hanmi Pharm. Co., Ltd., Handok, Sanofi, Novo Nordisk. A. Alvarez: Employee; Sanofi. Stock/Shareholder; Sanofi. F. Lauand: Employee; Sanofi. Stock/Shareholder; Sanofi. Y. Ren: Consultant; Sanofi. Employee; Aixial. S. Yoo: None.

Funding
Sanofi
796-P: Glucose-Lowering Drugs and Risk of COPD Exacerbations in Adults with Type 2 Diabetes
Authors: RAY AVIK , PAIK JULIE M. , FELDMAN WILLIAM B. , KATTINAKERE SREEDHARA SUSHAMA , WEXLER DEBORAH J. , PATORNO ELISABETTA 
Published: June 2024

Introduction & objective: Recent studies suggest a possible therapeutic role of glucose-lowering drugs for chronic obstructive pulmonary disease (COPD). We compared sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP1-RA), and dipeptidyl peptidase 4 inhibitors (DPP4i) regarding the risk of COPD exacerbations.
Methods: Using data from a US commercial claims database (2013-2023), we identified 7,472 pairs of 1:1 propensity score (PS) matched adults aged &gt;=40 years with type 2 diabetes (T2D) initiating SGLT2i or DPP4i, 7,600 pairs initiating GLP1-RA or DPP4i, and 10,187 pairs initiating SGLT2i or GLP1-RA. We estimated HRs and 95% CIs for the risk of a COPD exacerbation, defined as an inpatient COPD diagnosis (severe exacerbation) or an outpatient COPD diagnosis and a filled prescription of oral prednisone (moderate exacerbation), adjusting for 91 covariates.
Results: The risk of moderate or severe COPD exacerbation was lower in the SGLT2i (HR, 0.79; 95% CI, 0.71-0.88) and the GLP1-RA (HR, 0.79; 95% CI, 0.71-0.88) groups compared with DPP4i, and was similar between SGLT2i and GLP1-RA (HR, 0.93; 95% CI, 0.83-1.03), over a median follow-up of 4.3 months on treatment (Table). Results were consistent in subgroup analyses based on asthma history.
Conclusion: SGLT2i and GLP1-RA were associated with reduced risk of moderate or severe COPD exacerbations, compared to DPP4i in adults with T2D.

Disclosure
A. Ray: None. J.M. Paik: None. W.B. Feldman: None. S. Kattinakere Sreedhara: None. D.J. Wexler: Other Relationship; Novo Nordisk. E. Patorno: Research Support; Boehringer-Ingelheim, Food and Drug Administration (FDA), National Institutes of Health, Patient-Centered Outcomes Research Institute.
801-P: TRIM—Teen Obesity and GLP-1 Receptor Agonists—Insights from a Systematic Review, Meta-analysis, and Drug-Wise Network Meta-analysis
Authors: AAQIB SHAMIM MUHAMMAD , RASTOGI ASHU , SINGH SURJIT , CHENCHULA SANTENNA , GANESH VENKATA , TIWARI KRISHNA , BABU VARTHYA SHOBAN , DWIVEDI PRADEEP , SHUKLA RAVINDRA , RAO PRIYANKA , SATAPATHY PRAKISINI , PATIL AMOL , AMIN ULFAT , ROY TULI , P GANDHI ARAVIND , SAH RANJIT 
Published: June 2024

Introduction & Objective: Obesity in adolescents is linked with adverse health outcomes. GLP1RAs have provided promising but conflicting results. We summarised the evidence for GLP1RAs in adolescents with obesity for weight-related outcomes.
Methods: We screened PubMed, Cochrane, Scopus, and Web of Science till 2023/04/29 for eligible RCTs. We compared GLP1RAs vs placebo, and then individual GLP1RAs in a network meta-analysis. We used a random effects model to account for the clinical heterogeneity, used the clinically more interpretable prediction intervals (PI), and assessed study quality and evidence quality.
Results: We identified 12 RCTs mostly at a low risk of bias. GLP1RAs led to a greater weight reduction [-4.21 kg; 95% CI -7.08 to -1.35; 95% PI -14.44 to 6.01; 11 RCTs; 818 participants; high quality evidence]. There is also reduction in BMI and waist circumference. The results are consistent in subgroup analyses for coexisting T2D. There is greatest efficacy with Semaglutide followed by Exenatide, Liraglutide, and Lixisenatide [Figure].
Conclusion: GLP1RAs reduce weight-related outcomes in adolescents with Semaglutide being the most efficacious. RCTs with direct comparisons, pragmatic study design, longer follow-up (to generate or verify safety signals), and adiposity-related outcomes are needed to further guide the usage and choice of GLP1RAs.

Disclosure
M. Shamim: None. A. Rastogi: None. S. Singh: None. S. Chenchula: None. V. Ganesh: None. K. Tiwari: None. S. Varthya: None. P. Dwivedi: None. R. Shukla: None. P. Rao: None. P. Satapathy: None. A. Patil: None. U. Amin: None. T. Roy: None. A. Gandhi: None. R. Sah: None.
802-P: A New Dawn beyond Basal Insulin? Dose-Response Meta-analysis for Efficacy and Safety of Tirzepatide Compared with Basal Insulin in Uncontrolled Diabetes Mellitus
Authors: AAQIB SHAMIM MUHAMMAD , DWIVEDI PRADEEP , AGGARWAL PIYUSH , DWIVEDI RAKHI , ANIL ABHISHEK , SARAVANAN ASWINI , TIWARI KRISHNA , DODIYA RAKESH P. , YADAV ISHA , SUKHIJA SANCHI , BABU VARTHYA SHOBAN , SHUKLA RAVINDRA , SINGH SURJIT , SINGH KULDEEP 
Published: June 2024

Introduction & Objective: Insulin is the mainstay for uncontrolled type 2 diabetes mellitus (T2D) but is associated with hypoglycemia and weight gain. Tirzepatide is a first-in-class dual incretin GLP-1/GIP analog. We assessed the efficacy and safety of Tirzepatide compared to basal insulin for uncontrolled T2D.
Methods: We searched PubMed, Scopus, and CENTRAL till 2023/08/02 for relevant RCTs. We compared Tirzepatide 15mg once weekly with basal insulin, and then various doses after confirming dose-response linearity by Wald’s test. Then, we graded the evidence quality. Protocol: CRD42023450278 [PROSPERO]
Results: We identified 4,339 patients from 3 RCTs. Tirzepatide 15mg has a greater reduction in HbA1c [-1.23%, -1.53 to -0.93] compared to basal insulin. The 95% prediction interval for expected reduction in clinical practice is -5.04 to 2.58. More patients had &gt;5% weight loss [RR 13.75, 9.91 - 19.09] and adverse events [RR 1.95, 1.66 - 2.30], but not serious adverse events [RR 0.78, 0.53 - 1.16]. There is considerable dose-dependent improvement in efficacy [Figure].
Conclusion: High quality evidence suggests Tirzepatide leads to better glycemic control with an acceptable safety profile, along with benefits like weight loss and decreased frequency of administration. Future studies can inform dose optimization and long-term safety.

Disclosure
M. Shamim: None. P. Dwivedi: None. P. Aggarwal: None. R. Dwivedi: None. A. Anil: None. A. Saravanan: None. K. Tiwari: None. R.P. Dodiya: None. I. Yadav: None. S. Sukhija: None. S. Varthya: None. R. Shukla: None. S. Singh: None. K. Singh: None.