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Journal Article Ppublish 1 citation

PubMed: 39417493 DOI: 10.1177/19322968241289438

GLP-1 Receptor Agonists in Overweight and Obese Individuals With Type 1 Diabetes Using an Automated Insulin Delivery Device: A Real-World Study.

J Diabetes Sci Technol 19(2):286-291

Authors: Pernille Holmager, Merete Bechmann Christensen, Kirsten Nørgaard, Signe Schmidt

Affiliations

  • Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark.
  • Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Abstract

INTRODUCTION

Automated insulin delivery (AID) systems have improved glycemic control in individuals with type 1 diabetes (T1D) but overweight and increased cardiovascular risk remain a challenge. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with improved cardiometabolic profile but are currently not approved for the treatment of T1D.

MATERIAL AND METHODS

Individuals with T1D at Steno Diabetes Center Copenhagen, Denmark, treated with AID and off-label GLP-1 RA for at least six months between January 2017 and May 2024 were included in a retrospective chart review study.

RESULTS

Nineteen individuals with (median [range]) age 42 (24-60) years were included. At GLP-1 RA initiation, hemoglobin A1c (HbA1c) was 7.3% (6.1%-8.7%), HbA1c 56 (43-72) mmol/mol, body weight 91.5 (78.0-115.0) kg, and body mass index 35.4 (27.0-42.0) kg/m. Time in range was 74% (29%-82%), time above range 25% (18%-71%) while time below range was 1% (0%-5%). After six months of treatment, body weight changed -11% (-22% to -3%; = .001) and total daily insulin dose changed -15.1 (-32.5 to -8.2) IU ( = .004). There were no significant changes in HbA1c or other glucose measures. One person developed ketoacidosis caused by infusion set failure, but none reported severe hypoglycemia.

CONCLUSION

Glucagon-like peptide-1 receptor agonist as add-on therapy for six months in individuals with obesity and AID-treated T1D led to considerable weight loss and a reduction in insulin dose.

MeSH

Diabetes Mellitus, Glucagon-Like Peptide 1, Glucagon-Like Peptide-1 Receptor, Insulin, Body Weight, Therapeutics, Overweight, Diabetes Mellitus, Type 1

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