New research presented at the Peripheral Nerve Society (PNS) 2024 Annual Meeting suggested that tirzepatide, a dual gastric inhibitory polypeptide–glucagon-like peptide 1 (GIP–GLP-1) receptor agonist, may significantly reduce the risk of diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes. 

The analysis drew data from the TrinetX Global Health Research Network, which includes de-identified electronic health records from 83 healthcare organizations. Among the patients studied, 988,074 were not on any diabetes medications, while others were on insulin (328,574), metformin (387,130), semaglutide (27,776), empagliflozin (27,514), dulaglutide (21,972), liraglutide (4,225), and tirzepatide (2,146).

In the study, patients were matched for age, sex, race, body mass index, glucose levels (≥ 140 mL/mmol), and A1c levels (≥ 7) and followed for new-onset DPN at three intervals: 1 month, one year, and two years. The findings revealed that patients taking tirzepatide experienced a cumulative decrease in DPN risk over two years, from 4.8% to 3%. Conversely, the risk for those on insulin increased from 4.9% to 6.3%.

At specific time points, the reduction in DPN risk for tirzepatide users was notable: -0.6% at one month, -1.1% at one year, and -1.8% at two years. On the other hand, insulin users saw an increased risk of DPN: +0.2% at one month, +1.4% at one year, and +1.4% at two years. This translated to a relative risk (RR) of 3% for developing DPN at two years for tirzepatide users compared to an RR of 6.3% for insulin users.

Patients on metformin also showed a marginal decrease in DPN risk across all time points (-0.6%, -0.5%, -0.6%). The risk remained almost unchanged for semaglutide-treated patients, while those treated with dulaglutide and liraglutide initially showed decreased risk at one month but increased risk afterward.

(Source:https://www.medscape.com/viewarticle/reduced-risk-peripheral-neuropathy-tied-diabetes-medication-2024a1000buh )