Evaluating the effect of Semaglutide as add-on therapy on glycemic control and continuous glucose monitoring outcomes in adults with type 1 diabetes: A two-year real-world data study

May 3, 2025Journal of diabetes and its complications

Semaglutide added to treatment and blood sugar control in adults with type 1 diabetes over two years

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Abstract

By 24 months, the percentage of time in range (TIR) improved from 46% to 71% in adults with type 1 diabetes receiving GLP-1 receptor agonist therapy alongside insulin.

Continuous glucose monitoring metrics showed a significant increase in TIR from 46% to 71% and from 28.1% to 47.9% (p < 0.001).
Glycemic variability decreased, with the coefficient of variation falling from 46.3% to 33.6% (p < 0.001).
HbA1c levels improved from 8.2% to 7.1%, while the total daily insulin dose decreased from 1.4 to 0.7 IU/kg/day (p < 0.001).
Body weight and lipid profiles improved, with significant reductions in weight, LDL cholesterol, and triglycerides (p < 0.001 for weight and LDL, p < 0.05 for triglycerides).
No hospitalizations for diabetic ketoacidosis or major adverse cardiovascular events were reported during the study.

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AIMS: To evaluate the long-term efficacy of a GLP-1 receptor agonist (GLP-1RA, Semaglutide) as an adjunct to insulin therapy in adults with type 1 diabetes (T1D), using continuous glucose monitoring (CGM) metrics alongside weight and metabolic outcomes.

METHODS: In this retrospective chart review of adults with T1D on intensive insulin therapy, GLP-1RA was initiated and maintained for two years. Glycemic and metabolic parameters were evaluated at baseline, 12 months (T12), and 24 months (T24) during combination therapy.

RESULTS: A total of 67 adults with T1D (56.7 % males, 43.3 % females; mean age 31.8 years, SD: 6.11; mean diabetes duration 16.6 years, SD: 5.16) were included. By 24 months, we observed improved %TIRfrom 46 % to 71 % and %TIRfrom 28.1 % to 47.9 % (p < 0.001 for both). GRI, including CHypo and CHyper, showed sustained reductions, and glycemic variability improved, with CV% falling from 46.3 % to 33.6 % (p < 0.001). HbA1c improved from 8.2 % to 7.1 %, with total daily insulin dose decreasing from 1.4 to 0.7 IU/kg/day (p < 0.001). Body weight and lipid profile improved, with significant reductions in weight (p < 0.001), LDL (p < 0.001), and triglycerides (p < 0.05). No hospitalizations for DKA or major adverse cardiovascular events (MACE) occurred, and short discontinuation had no significant impact on metabolic or glycemic outcomes. 70-180 70-140

CONCLUSIONS: The adjunctive use of GLP-1RA in T1D shows potential for improving glycemic stability and metabolic parameters without increasing hypoglycemia risk. However, further studies are needed to confirm these effects across diverse populations and over more extended periods to fully establish their long-term efficacy and safety.

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Evaluating the effect of Semaglutide as add-on therapy on glycemic control and continuous glucose monitoring outcomes in adults with type 1 diabetes: A two-year real-world data study

Abstract

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