Skip to content
DraconiticResearch
Search Sources API
190,335 studies31 sourcesUpdated 18 min ago
Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Case Report: GADA-positive type 1 diabetes with diabetic ketoacidosis in a young adult with obesity temporally associated with unsupervised tirzepatide use for weight reduction

  • Mengyun Lei1
  • Fang Liu1
  • Li Sun1
  • Shuting Li1
  • Juan Liu1
  • Yonge Wang1
  • Jun Tang1
  1. 1Department of Endocrinology, Zhongnan Hospital of Wuhan University
Open at sourcePDFDOICite

Abstract

Background: Tirzepatide, a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonist, is widely used as an anti-obesity medication. Its safety in individuals with unrecognized type 1 diabetes (T1D) remains uncertain.

Case description: We describe a 28-year-old man with obesity and no previously documented hyperglycemia who self-administered tirzepatide, lost 15 kg over about 3 months, and was later diagnosed with GADA-positive T1D presenting as diabetic ketoacidosis (DKA) in temporal association with drug use and discontinuation. At admission, fasting blood glucose (FBG) was 13.99 mmol/L, glycated hemoglobin (HbA1c) 10.8% (95 mmol/mol), serum β-hydroxybutyrate 4.44 mmol/L, urine ketones (+++), serum bicarbonate 16.9 mmol/L, glutamic acid decarboxylase antibody (GADA) >2000 IU/mL, and fasting C-peptide 0.798 ng/mL. Admission arterial blood gas was not obtained. Insulin therapy was initiated; HbA1c was 6.7% (50 mmol/mol) at 3 months.

Conclusions: This single case cannot establish causality between tirzepatide exposure or discontinuation and autoimmune diabetes. It illustrates that adult-onset GADA-positive T1D with DKA may be recognized during or after unsupervised incretin-based weight reduction. Markedly elevated HbA1c indicated that hyperglycemia likely preceded the short symptomatic phase. The main clinical message is that autoimmune diabetes should be considered when unexplained hyperglycemia, ongoing weight loss, or ketoacidosis develops in this setting.

Related

  1. Pediatric stroke-like episodes temporally associated with pollen exposure in GJB1-related CMTX1: an expanded family case report with serial MRI and DTI follow-up
    Teng Yao, Yuanrui Li, Yajing Cheng +2
    BMC PediatricsPeer-reviewedCC BYFull textNeuroscienceDOAJ
  2. Prefrontal Glx Reduction during the Sleep Transition Is Associated with Sleep-Onset Latency
    Takashi Yamada, Aaron Cochrane, Theodore LaBonte-Clark +2
    The Journal of NeurosciencePeer-reviewedPublisher termsFull textNeurosciencePMC
  3. APOE4 reduction in vascular-associated fibroblasts decreases cerebral amyloid angiopathy and associated vascular dysfunction
    F. Saadi, Y. Cho, I. V. Katritch +15
    bioRxivPreprintAll rights reservedFull textNeurosciencebioRxiv
  4. Neural dynamics of reconstructing knowledge structure from temporally disordered inputs
    Xinran Xu, Xiangyu He, Siyuan Zhou +2
    Communications BiologyPeer-reviewedCC BY-NC-ND 4.0Full textNeuroscienceCrossref
  5. Ixekizumab With or Without Tirzepatide in Adults With Psoriasis and Overweight or Obesity
    Mark Lebwohl, Andrew Blauvelt, Cynthia E. Kartman +15
    JAMA DermatologyPeer-reviewedLicence not stated22 citedImmunologyOpenAlex

Cite

BibTeXRIS
BibTeX
@article{lei2026case,
  title = {{Case Report: GADA-positive type 1 diabetes with diabetic ketoacidosis in a young adult with obesity temporally associated with unsupervised tirzepatide use for weight reduction}},
  author = {Mengyun Lei and Fang Liu and Li Sun and Shuting Li and Juan Liu and Yonge Wang and Jun Tang},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1995854},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1995854/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Case Report: GADA-positive type 1 diabetes with diabetic ketoacidosis in a young adult with obesity temporally associated with unsupervised tirzepatide use for weight reduction
AU  - Mengyun Lei
AU  - Fang Liu
AU  - Li Sun
AU  - Shuting Li
AU  - Juan Liu
AU  - Yonge Wang
AU  - Jun Tang
PY  - 2026
DA  - 2026/10/22
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1995854
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1995854/full
AB  - Background: Tirzepatide, a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonist, is widely used as an anti-obesity medication. Its safety in individuals with unrecognized type 1 diabetes (T1D) remains uncertain.  Case description: We describe a 28-year-old man with obesity and no previously documented hyperglycemia who self-administered tirzepatide, lost 15 kg over about 3 months, and was later diagnosed with GADA-positive T1D presenting as diabetic ketoacidosis (DKA) in temporal association with drug use and discontinuation. At admission, fasting blood glucose (FBG) was 13.99 mmol/L, glycated hemoglobin (HbA1c) 10.8% (95 mmol/mol), serum β-hydroxybutyrate 4.44 mmol/L, urine ketones (+++), serum bicarbonate 16.9 mmol/L, glutamic acid decarboxylase antibody (GADA) >2000 IU/mL, and fasting C-peptide 0.798 ng/mL. Admission arterial blood gas was not obtained. Insulin therapy was initiated; HbA1c was 6.7% (50 mmol/mol) at 3 months.  Conclusions: This single case cannot establish causality between tirzepatide exposure or discontinuation and autoimmune diabetes. It illustrates that adult-onset GADA-positive T1D with DKA may be recognized during or after unsupervised incretin-based weight reduction. Markedly elevated HbA1c indicated that hyperglycemia likely preceded the short symptomatic phase. The main clinical message is that autoimmune diabetes should be considered when unexplained hyperglycemia, ongoing weight loss, or ketoacidosis develops in this setting.
SN  - 1664-2392
ER  -