Clinical efficacy of tirzepatide for weight regain and suboptimal glycemic control following laparoscopic sleeve gastrectomy: a case series of three patients with obesity-associated type 2 diabetes
Abstract
Background: Laparoscopic sleeve gastrectomy is an effective metabolic surgery; however, some patients experience weight regain and worsening of type 2 diabetes mellitus (T2DM) over the long term. Tirzepatide (TZP), a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated potent weight loss and glucose-lowering effects. This study evaluated the clinical outcomes of TZP treatment in patients facing weight regain and insufficient glycemic control after LSG.
Methods and results: We performed a retrospective clinical analysis of three male patients with obesity-associated T2DM who developed significant weight regain and suboptimal glycemic control several years after undergoing LSG. Despite repeated nutritional counseling and behavioral modification, their conditions remained refractory. Following the initiation of weekly TZP treatment, all three patients achieved substantial weight reduction and significant improvements in HbA1c levels. Specifically, Case 1 achieved a total weight loss (%TWL) of 14.0% from the pre-LSG baseline (13.2% weight loss specifically from TZP initiation) over 12 months. Case 2 achieved a %TWL of 13.2% from the pre-LSG baseline (8.5% weight loss from TZP initiation) over 6 months. Case 3 achieved a %TWL of 27.3% from the pre-LSG baseline (28.7% weight loss from TZP initiation) over 9 months. Notably, all patients reached HbA1c levels below 6.0% (range: 5.2%-5.6%), surpassing the…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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