INTRODUCTION: This research is designed to compare the clinical characteristics, metabolic outcomes, and safety profiles of patients with Type 1 Diabetes (T1D) treated with Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) against Sodium-Glucose co-transporter 2 (SGLT2) inhibitors in a real-world clinical setting over 12 months.
METHODS: Data from 112 adult T1D patients on intensive insulin therapy at Prince Sultan Military Medical City in Riyadh were examined for this retrospective cohort study. Among the 112 T1D, 96 were treated with GLP-1 receptor agonists and 16 were treated with SGLT2 inhibitors. Baseline demographics, the presence of comorbidities, diabetes complications, glycemic control (HbA1c), weight, insulin dosage, renal function, and lipid profiles were assessed at initiation and after 12 months of treatment.
RESULTS: Patients getting GLP-1 receptor agonists were younger (p = 0.006), had shorter diabetes duration (p = 0.030), and were more likely to use insulin pumps (p = 0.040). The SGLT2 group showed significantly higher albumin-to-creatinine ratios (p = 0.047) and higher statin use (p = 0.038). GLP-1 therapy led to significant HbA1c (p < 0.05) and weight reduction, while SGLT2 treatment improved renal markers and reduced insulin dose. LDL cholesterol decreased significantly in the GLP-1 group (p = 0.014),while the SGLT2 group showed more favorable changes in HDL and total cholesterol. Comorbidities and diabetes related complications were similar between groups.
DISCUSSION: GLP-1 RAs produced notable reductions in HbA1c levels and weight reduction, while SGLT2 inhibitors offered renal protection and decreased insulin needs. These real-world findings emphasize the value of tailoring adjunct therapies to each patient's profile. Personalized treatment strategies are crucial for optimizing metabolic outcomes in T1D.
CONCLUSION: Both GLP-1 RAs and SGLT2 inhibitors effectively improve glycemic control and cardiovascular risk markers in T1D, with distinct advantages in weight loss and renal function, respectively. These findings highlight the value of personalized adjunct therapy choices to optimize patient outcomes. Larger prospective studies are needed to confirm long-term benefits and safety.
