From the Guidelines
Yes, Glucagon-like peptide-1 (GLP-1) can be used in patients with Type 1 Diabetes Mellitus, although it is not currently FDA-approved for this indication.
Rationale
- The use of GLP-1 receptor agonists, such as liraglutide, has been studied in patients with type 1 diabetes and has shown benefit in improving hemoglobin A1c levels and reducing body weight 1.
- However, the use of GLP-1 receptor agonists in type 1 diabetes is also associated with increased adverse events, including hypoglycemia and hyperglycemia with ketosis 1.
- The 2023 standards of care in diabetes suggest considering GLP-1 RA or GIP/GLP-1 RA in most individuals prior to insulin, but this is in the context of type 2 diabetes management 1.
- In the context of type 1 diabetes, GLP-1 agonists and DPP-4 inhibitors are being studied, but are not currently FDA-approved for use in this population 1.
Key Points
- GLP-1 receptor agonists may be considered in patients with type 1 diabetes who have not achieved blood glucose goals with insulin therapy alone.
- The use of GLP-1 receptor agonists in type 1 diabetes requires careful consideration of the potential benefits and risks, including increased adverse events.
- More research is needed to fully understand the role of GLP-1 receptor agonists in the management of type 1 diabetes.
From the Research
Use of GLP-1 in Type 1 Diabetes Mellitus
- The use of Glucagon-like peptide-1 (GLP-1) receptor agonists as an adjunctive treatment for individuals with Type 1 Diabetes Mellitus (T1D) has been explored in several studies 2, 3, 4, 5.
- A consensus report published in 2025 found that GLP-1 receptor agonists have the potential to provide effective adjunct therapy and improve glycemic and metabolic outcomes in adults with T1D using automated insulin delivery systems, without increasing the risk of severe hypoglycemia or diabetic ketoacidosis 2.
- Another study published in 2024 discussed the potential of GLP-1 agonists in managing T1D, particularly focusing on their impact on glycemic control, weight management, and glucagon dysregulation 3.
- A review published in 2016 evaluated the clinical efficacy and safety of GLP-1 receptor agonists in patients with T1D and found that they can provide significant reductions in hemoglobin A1C, plasma glucose concentration, body weight, and insulin doses, without increasing the occurrence of hypoglycemia 4.
- However, it is worth noting that GLP-1 receptor agonists are currently not approved by the US Food and Drug Administration for the treatment of T1D in the absence of randomized controlled trials documenting efficacy and safety of these agents in this population 2.
Potential Benefits and Risks
- The potential benefits of using GLP-1 receptor agonists in T1D include improved glycemic control, weight loss, and reduced insulin doses 2, 3, 4.
- However, the use of GLP-1 receptor agonists in T1D also carries potential risks, such as hypoglycemia unawareness and dysregulated glucagon response 3.
- Further research is needed to fully understand the benefits and risks of using GLP-1 receptor agonists in T1D and to determine their potential as a treatment option for this population 2, 3, 4, 5.