ADA Scientific Sessions 2025 Abstract · Jun 13, 2025
Elevated BMI and Antiobesity Medication Prevalence in Adults with Type 1 Diabetes—Cross-Sectional Study of the Epic Cosmos Database
By SANCHEZ M, REYES N, BARROS A et al.
Introduction and Objective: Excess adiposity leads to insulin resistance, which augments cardiorenal risk in type 1 diabetes (T1D). Limited data exists regarding anti-obesity medication (AOM) prescribing practices in T1D despite obesity/overweight rates comparable to the general population. Our aim was to determine recent prevalence of elevated body mass index (BMI) and AOM use in a cohort of adults with T1D. Methods: This cross-sectional study examined Epic Cosmos electronic healthcare record data of adults, aged ≥ 18 years, with active problem list ICD-10 diagnosis for T1D (E10.x) and ≥ 2 face-to-face encounters in 2 year periods between 1/1/2017-12/31/2024. We queried prevalence of: 1) BMI 27 to <30 kg/m2, or ≥30 kg/m2, and 2) active AOM’s: phentermine, semaglutide, tirzepatide, liraglutide, orlistat, phentermine/topiramate, and naltrexone/bupropion. Results: In 2017, 20.1% had BMI 27 to <30 kg/m2 and 27.5% had BMI ≥ 30 kg/m2. By 2024, this increased to 22.9% and 33% respectively. AOM use increased from 1.9% (6,589 of 297,399) in 2017 to 13.9% (99,307 of 587,437) in 2024. While weekly incretin based treatments increased exponentially, other treatments were uncommon (Table). Conclusion: Overweight/obesity was common in this cohort. Although AOM use increased, a small portion of adults with BMI ≥ 27 kg/m2 are receiving treatment. Further study of anti-obesity medication safety and efficacy in people with T1D is needed. Disclosure: M. Sanchez: None. N. Reyes: None. A. Barros: None. A. Kinlaw: None. K. Love: None. Funding: National Institutes of Health (K23DK131327-01A1)