From the Guidelines
Yes, Glucagon-like peptide-1 (GLP-1) can be used in patients with Type 1 Diabetes Mellitus, but it is not currently FDA-approved for this indication and its use is still being studied.
Key Points
- GLP-1 receptor agonists, such as liraglutide, have shown benefit in patients with type 1 diabetes, improving HbA1c levels and reducing body weight, but are associated with increased adverse events, including hypoglycemia and hyperglycemia with ketosis 1, 2.
- The use of GLP-1 receptor agonists in type 1 diabetes is still investigational and not currently FDA-approved, but they are being studied as an adjunct to insulin therapy 3, 4.
- In clinical practice, the use of GLP-1 receptor agonists in type 1 diabetes should be approached with caution, considering the potential benefits and risks, and patient preferences, cost, and potential side effects should be taken into account 3.
- There is currently no evidence to support the routine use of GLP-1 receptor agonists in children with type 1 diabetes, and their use in this population has not been thoroughly studied 5.
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 6, 7, 8, 9.
- 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 6.
- Another study published in 2024 discussed the role of GLP-1 agonists in managing T1D, particularly focusing on their impact on glycemic control, weight management, and glucagon dysregulation 7.
- A review published in 2016 evaluated the available literature on the clinical efficacy and safety of GLP-1 receptor agonists in patients with T1DM and found that they can reduce hemoglobin A1C, plasma glucose concentration, body weight, and insulin doses without increasing the occurrence of hypoglycemia 8.
- A study published in 2009 summarized the present knowledge of GLP-1 and its analogues regarding its role as a possible treatment in patients with T1D and suggested that future studies should explore the potential of GLP-1 as an adjuvant therapy in islet cell transplantation 9.
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 6, 7, 8.
- However, the use of GLP-1 receptor agonists in T1D also carries potential risks, such as gastrointestinal adverse events, hypoglycemia unawareness, and dysregulated glucagon response 7, 10.
- A study published in 2014 found that the combination of basal insulin and GLP-1 receptor agonists can reduce hemoglobin A1C and body weight without significantly increasing hypoglycemia, but gastrointestinal adverse events are common, especially during initiation and titration 10.
Patient Selection and Future Directions
- Patients with T1D who may benefit from GLP-1 receptor agonists are those experiencing adverse effects from insulin, those not at their A1C goal but hypoglycemia prevents insulin titration, and those who may benefit from weight loss 8.
- Future studies should explore the potential of GLP-1 as an adjuvant therapy in islet cell transplantation and investigate the effects of GLP-1 on beta-cell mass and function in T1D 9.
- The expert panel members in the consensus report published in 2025 identified research gaps and future directions for research, including the need for randomized controlled trials to document the efficacy and safety of GLP-1 receptor agonists in T1D 6.