UCSF

Type 1 diabetes (T1D) necessitates lifelong insulin therapy due to the autoimmune destruction of insulin-producing pancreatic beta cells. Despite advancements in diabetes technology and insulin formulations, maintaining optimal glycemic outcomes remains challenging in these individuals. Obesity, accompanied by insulin resistance, is common not only in type 2 diabetes (T2D) but also in many individuals with T1D. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), approved for T2D and obesity, are now being explored for off-label use in individuals with T1D. This review examines their efficacy, safety, and potential benefits in T1D management. We reviewed articles published up to May 2024 from databases like PubMed and Scopus, mainly focusing on human studies of GLP-1 RAs in T1D, as well as cardiorenal and metabolic outcomes in individuals with T2D and obesity. Semaglutide and other GLP-1 RAs showed significant improvements in glycemic outcomes, hemoglobin A1c levels, reduced insulin doses, and notable weight loss. Studies in individuals with obesity and T2D showed significant improvements in lipid profile and offered cardiorenal protection. Common side effects include gastrointestinal issues, and while some studies reported hypoglycemia, hyperglycemia, and ketosis, others did not. Despite these challenges, GLP-1 RAs offer significant therapeutic benefits, making them a promising adjunct to insulin therapy for improving clinical outcomes in T1D management.