From the Guidelines
GLP-1 is not currently a standard treatment for Type 1 Diabetes Mellitus, but it is being studied as a potential adjunct therapy to insulin.
Key Points
- GLP-1 receptor agonists, such as liraglutide, have shown benefit in patients with type 1 diabetes by improving hemoglobin A1c levels and reducing body weight 1.
- However, the use of GLP-1 receptor agonists in type 1 diabetes is associated with increased adverse events, including hypoglycemia and hyperglycemia with ketosis 1.
- The study on liraglutide in type 1 diabetes showed that hemoglobin A1c levels improved by 0.34 to 0.54 percentage point from a mean baseline of 8.2% with once-daily injections of liraglutide (1.8,1.2, or 0.6 mg) added to insulin therapy 1.
- Body weight reduction was 2.2 to 4.9 kg greater with liraglutide than placebo, but hypoglycemia rates increased by 20% to 30% 1.
- Due to the potential risks and lack of standardization, GLP-1 receptor agonists should be used with caution in type 1 diabetes, and only under the guidance of a healthcare professional.
Important Considerations
- Patients with type 1 diabetes who are considering GLP-1 receptor agonists should be closely monitored for signs of hypoglycemia and hyperglycemia with ketosis.
- The use of GLP-1 receptor agonists in type 1 diabetes is still investigational and not currently approved by the U.S. Food and Drug Administration.
From the Research
GLP-1 Suitability for Type 1 Diabetes Mellitus
- GLP-1 receptor agonists have been studied as a potential treatment option for type 1 diabetes mellitus (T1DM) due to their ability to reduce hemoglobin A1c (A1C) levels, promote weight loss, and decrease insulin doses without increasing the risk of hypoglycemia 2, 3, 4.
- The mechanism of action of GLP-1 receptor agonists, which includes glucose-dependent insulin secretion, reduced glucagon secretion, increased satiety, and delayed gastric emptying, makes them a potential adjunctive treatment for T1DM 2, 3.
- Clinical trials have shown that GLP-1 receptor agonists, such as exenatide and liraglutide, can improve glycemic control, reduce body weight, and decrease insulin doses in patients with T1DM 2, 3, 4.
- The use of GLP-1 receptor agonists in T1DM may be beneficial for patients who are overweight or obese, have difficulty achieving glycemic goals with insulin therapy, or experience adverse effects from insulin 2, 3, 4.
Patient Selection and Benefits
- Patients with T1DM who may benefit from GLP-1 receptor agonist therapy include those with detectable C-peptide, overweight or obese individuals, and those who cannot achieve glycemic goals without hypoglycemia 3, 4.
- GLP-1 receptor agonists may provide effective adjunct therapy and improve glycemic and metabolic outcomes without increasing the risk of severe hypoglycemia or diabetic ketoacidosis in adults with T1DM using automated insulin delivery systems 5.
- The potential benefits of GLP-1 receptor agonists in T1DM include improved glycemic control, weight loss, and reduced insulin doses, making them a valuable treatment option for patients with T1DM 2, 3, 4.
Safety and Tolerability
- GLP-1 receptor agonists are generally well-tolerated in patients with T1DM, with gastrointestinal adverse effects being the most common side effect 2, 3, 4.
- The risk of hypoglycemia with GLP-1 receptor agonist therapy is low, and these agents do not appear to increase the risk of severe hypoglycemia or diabetic ketoacidosis in patients with T1DM 2, 3, 5.
- Further studies are needed to evaluate the long-term safety and efficacy of GLP-1 receptor agonists in patients with T1DM 3, 6.