{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T07:57:15Z","timestamp":1785571035005,"version":"3.56.0"},"reference-count":11,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Although tirzepatide efficaciously reduces glucose concentrations and weight, phase 3 trials evaluated patients with a body mass index (BMI) \u226523\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    . Consequently, clinical evidence in patients with type 2 diabetes but no obesity, common in Asia, is insufficient. In this secondary analysis of the multicentre, real\u2010world Hokkaido\u2010TZP study, we evaluated 107 Japanese patients with T2D and BMI &lt;25.0\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    . Over 6\u2009months, tirzepatide significantly reduced HbA1c in all the BMI tertiles (Low, Middle, High). Seven patients discontinued treatment due to adverse events; notably, all belonged to the Low or Middle BMI groups. The overall BMI also significantly decreased, but the reduction was more pronounced in participants with higher baseline BMIs. Multiple regression analysis identified baseline BMI and dietary consultations as significant independent factors contributing to the BMI reduction. Thus, tirzepatide provides effective glycaemic control in patients without obesity, and its weight\u2010lowering effect might be modulated by baseline BMI and lifestyle interventions.\n                  <\/jats:p>","DOI":"10.1111\/jdi.70355","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T03:53:18Z","timestamp":1781495598000},"page":"1304-1309","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of tirzepatide in Japanese patients with type 2 diabetes but no obesity: A\u00a0sub\u2010analysis of Hokkaido\u2010\n                    <scp>TZP<\/scp>\n                    study data"],"prefix":"10.1111","volume":"17","author":[{"given":"Tomoe","family":"Abe","sequence":"first","affiliation":[{"name":"Sapporo Diabetes and Thyroid Clinic  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumika","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism, and Rheumatology, Department of Internal Medicine Asahikawa Medical University  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisuke","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism, and Rheumatology, Department of Internal Medicine Asahikawa Medical University  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Ito","sequence":"additional","affiliation":[{"name":"Kurihara Clinic  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukie","family":"Miyano","sequence":"additional","affiliation":[{"name":"Sapporo Diabetes and Thyroid Clinic  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Yamagata","sequence":"additional","affiliation":[{"name":"Department of Diabetology and Endocrinology Japanese Red Cross Asahikawa Hospital  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiga","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Diabetology and Endocrinology Asahikawa City Hospital  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemitsu","family":"Sakagami","sequence":"additional","affiliation":[{"name":"Department of Diabetology and Endocrinology Asahikawa City Hospital  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8192-0006","authenticated-orcid":false,"given":"Akinobu","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine Hokkaido University  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0713-221X","authenticated-orcid":false,"given":"Hiroshi","family":"Nomoto","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Metabolism, and Rheumatology, Department of Internal Medicine Asahikawa Medical University  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Hokkaido\u2010TZP Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-022-05715-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2023.2184796"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2004.02.012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110674"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.70734"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ23-0593"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14952"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15887"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-012-2827-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-018-0332-4"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2024.05.010"}],"container-title":["Journal 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