Treatment of people with type 1 diabetes with Semaglutide or Tirzepatide – Relevant in the future?
Main Article Content
Abstract
For many people with type 1 diabetes optimizing glucose control is very demanding, and often leads to risk of hypoglycaemia and weight gain and more than half of people with type 1 diabetes are overweight or obese. Glucagon-like peptide-1 (GLP-1) based pharmacotherapy is established as treatment of people with type 2 diabetes and obesity but are not recommended for treatment of type 1 diabetes. GLP-1 based pharmacotherapy has also beneficial effects on cardiovascular and kidney disease, which also are complications to type 1 diabetes. Prescription of GLP-1 based pharmacotherapy has become increasing popular as add-on treatment to insulin in type 1 diabetes. The most potent GLP-1 receptor agonist semaglutide and the dual GLP-1/glucose-dependent insulinotropic peptide tirzepatide have been investigated in small trials, primarily retrospective chart reviews in type 1 diabetes. The present narrative review assesses up to August 2025 the efficacy and safety of semaglutide and tirzepatide on glycaemic control, body weight, dose of insulin and adverse events. Two small, randomized trial has been published with semaglutid reporting weight loss of 5.3 kg and 9.2 kg, reduction of daily dose of insulin up to 30%. The reduction in HbA1c was about - 0.3% to - 0.5% with increased continuous glucose monitoring (CGM) time in range. With tirzepatide the weight loss has been between 10-20 kg and with major reduction (up to> 30%) in dose of insulin combined with small reduction in HbA1c but with increased CGM time in range. Hypoglycaemia and ketoacidosis have not been a problem in the studies with semaglutide and tirzepatide. The effect of semaglutide and tirzepatide on risk of cardiovascular and kidney disease in people with type 1 diabetes has not been investigated. Major, long-term, randomized, placebo-controlled trials to define the place of GLP-1 based pharmacotherapy in the treatment algorithm of people with different phenotypes of type 1 diabetes are warranted.
Keywords:
Type 1 diabetes, GLP-1 receptor agonist, GLP-1/GIP agonist, Semaglutide, Tirzepatide
Article Details
How to Cite
MADSBAD, Sten.
Treatment of people with type 1 diabetes with Semaglutide or Tirzepatide – Relevant in the future?.
Medical Research Archives, [S.l.], v. 13, n. 9, sep. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6925>. Date accessed: 06 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i9.6925.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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4. Bailey R, Calhoun P, Garg SK. Weight Gain and Glycemic Control in Adults with Type 1 Diabetes in the T1D Exchange Registry. Diabetes Technol Ther. 2024;26(3):156-160. doi:10.1089/dia.2023.0389
5. Karakus KE, Akturk HK, Alonso GT, Snell-Bergeon JK, Shah VN. Association Between Diabetes Technology Use and Glycemic Outcomes in Adults With Type 1 Diabetes Over a Decade. Diabetes Care. 2023;46(9):1646-1651. doi:10.2337/dc23-0495
6. Jacobs PG, Levy CJ, Brown SA, et al. Research Gaps, Challenges, and Opportunities in Automated Insulin Delivery Systems. J Diabetes Sci Technol. 2025;19(4): 937-949. doi:10.1177/19322968251338754
7. Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rev. 2007;87(4):1409-1439. doi:10.1152/ physrev.00034.2006
8. Johansen NJ, Dejgaard TF, Lund A, et al. Efficacy and safety of meal-time administration of short-acting exenatide for glycaemic control in type 1 diabetes (MAG1C): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2020;8(4):313-324. doi:10.1016/S2213-8587(20) 30030-9
9. Madsbad S, Holst JJ. Cardiovascular effects of incretins: focus on glucagon-like peptide-1 receptor agonists. Cardiovasc Res. 2023;119(4):886-904. doi:10.1093/cvr/cvac112
10. Madsbad S, Holst JJ. The promise of glucagon-like peptide 1 receptor agonists (GLP-1RA) for the treatment of obesity: a look at phase 2 and 3 pipelines. Expert Opin Investig Drugs. 2025;34(3): 197-215. doi:10.1080/13543784.2025.2472408
11. Xu Y, Echouffo Tcheugui JB, Coresh J, et al. Trends in obesity and glucagon-like peptide-1 receptor agonist prescriptions in type 1 diabetes in the United States. Diabetes Obes Metab. 2025;27(6):2967-2976. doi:10.1111/dom.16300
12. Kilpatrick ES, Rigby AS, Atkin SL. Insulin resistance, the metabolic syndrome, and complication risk in type 1 diabetes: “double diabetes” in the Diabetes Control and Complications Trial. Diabetes Care. 2007;30(3):707-712. doi:10.2337/dc06-1982
13. Pasqua MR, Tsoukas MA, Kobayati A, Aboznadah W, Jafar A, Haidar A. Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial. Nat Med. 2025;31(4):1239-1245. doi:10.1038/s41591-024-03463-z
14. Shah VN, Akturk HK, Kruger D, et al. Semaglutide in Adults with Type 1 Diabetes and Obesity. NEJM evidence. Published online June 2025:EVIDoa2500 173. doi:10.1056/EVIDoa2500173
15. Navodnik MP, Janež A, Žuran I. The Effect of Additional Treatment with Empagliflozin or Semaglutide on Endothelial Function and Arterial Stiffness in Subjects with Type 1 Diabetes Mellitus-ENDIS Study. Pharmaceutics. 2023;15(7). doi:10. 3390/pharmaceutics15071945
16. Dandona P, Chaudhuri A, Ghanim H. Semaglutide in Early Type 1 Diabetes. N Engl J Med. 2023;389 (10):958-959. doi:10.1056/NEJMc2302677
17. Dandona P, Chaudhuri A, Ghanim H. More on Semaglutide in Early Type 1 Diabetes. Reply. N Engl J Med. 2024;390(3):292. doi:10.1056/NEJMc2311 608
18. Grassi BA, Teresa Onetto M, Sánchez C, Tapia N, Mena F. Effect of low dose Semaglutide in people with Type 1 Diabetes and excess weight. Diabetes Res Clin Pract. 2024;209:111593. doi:10.1016/j. diabres.2024.111593
19. Orrange S, Humphrey T, Fayne E, Peters A. Semaglutide for Weight Reduction in Type 1 Diabetes: Promising Results With Uncertain Glycemic Impact. J Diabetes Sci Technol. 2025;19(2):593-594. doi:10.1177/19322968241304779
20. Garg SK, Kaur G, Haider Z, Rodriquez E, Beatson C, Snell-Bergeon J. Efficacy of Semaglutide in Overweight and Obese Patients with Type 1 Diabetes. Diabetes Technol Ther. 2024;26(3):184-189. doi:10.1089/dia.2023.0490
21. Al Hayek A, Klonoff DC, Al Zahrani WM, Ibrahim SE, Al Dawish MA. 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. J Diabetes Complications. 2025;39(7):109064. doi:10.1016/j.jdiacomp.2025.109064
22. Cohen N, Yeung A, Jenkins A. Real-world experience of adjunct weekly semaglutide in Type 1 diabetes. Is it worth it? Diabetes Res Clin Pract. 2025;219:111979. doi:10.1016/j.diabres.2024.111979
23. Almohareb SN, Alfayez OM, Aljuaid SS, et al. Effectiveness and Safety of GLP-1 Receptor Agonists in Patients with Type 1 Diabetes. J Clin Med. 2024;13(21). doi:10.3390/jcm13216532
24. Garg SK, Kaur G, Renner D, et al. Cardiovascular and Renal Biomarkers in Overweight and Obese Adults with Type 1 Diabetes Treated with Tirzepatide for 21 Months. Diabetes Technol Ther. 2025;27(3):152-160. doi:10.1089/dia.2024.0481
25. Garg SK, Akturk HK, Kaur G, Beatson C, Snell-Bergeon J. Efficacy and Safety of Tirzepatide in Overweight and Obese Adult Patients with Type 1 Diabetes. Diabetes Technol Ther. 2024;26(6):367-374. doi:10.1089/dia.2024.0050
26. Karakus KE, Klein MP, Akturk HK, Shah VN. Changes in Basal and Bolus Insulin Requirements with Tirzepatide as an Adjunctive Therapy in Adults with Type 1 Diabetes Using Tandem Control-IQ. Diabetes Ther. 2024;15(7):1647-1655. doi:10.1007/s13300-024-01592-9
27. Akturk HK, Dong F, Snell-Bergeon JK, Karakus KE, Shah VN. Efficacy and Safety of Tirzepatide in Adults With Type 1 Diabetes: A Proof of Concept Observational Study. J Diabetes Sci Technol. Published online February 2024:19322968231223990. doi:10.1177/19322968231223991
28. Rivera Gutierrez R, Tama E, Bechenati D, et al. Effect of Tirzepatide on Body Weight and Diabetes Control in Adults With Type 1 Diabetes and Overweight or Obesity. Mayo Clin Proc. 2025;100(2):265-275. doi:10.1016/j.mayocp.2024.07.006
29. Snell-Bergeon JK, Kaur G, Renner D, Akturk HK, Beatson C, Garg SK. Effectiveness of Semaglutide and Tirzepatide in Overweight and Obese Adults with Type 1 Diabetes. Diabetes Technol Ther. 2025;27(1):1-9. doi:10.1089/dia.2024.0328
30. Bezerra MF, Neves C, Neves JS, Carvalho D. Time in range and complications of diabetes: a cross-sectional analysis of patients with Type 1 diabetes. Diabetol Metab Syndr. 2023;15(1):244. doi:10.1186/s1309 8-023-01219-2
31. Lind M, Svensson AM, Kosiborod M, et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371(21):1972-1982. doi:10. 1056/NEJMoa1408214
32. Perkovic V, Tuttle KR, Rossing P, et al. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024;391(2): 109-121. doi:10.1056/NEJMoa2403347
33. Stougaard EB, Andersen MR, Bagger JI, et al. The Steno 1 study: Multifactorial intervention to reduce cardiovascular disease in type 1 diabetes-rationale and protocol of the prospective, randomized, open-labelled multicentre study. Diabetes Obes Metab. Published online July 2025. doi:10.1111/dom.16606
34. Frampton R, Snaith JR, Hocking S, Holmes-Walker J, Olsen N, Greenfield JR. Reducing cardiometabolic risk with semaglutide in type 1 diabetes (RESET1): Study protocol of a phase 2 double-blinded randomised placebo-controlled trial. Diabet Med. 2024;41(10):e15377. doi:10.1111/dme.15377
35. Mathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and Safety of Liraglutide Added to Insulin Treatment in Type 1 Diabetes: The ADJUNCT ONE Treat-To-Target Randomized Trial. Diabetes Care. 2016;39(10):1702-1710. doi:10.2337/dc16-0691
36. Ahrén B, Hirsch IB, Pieber TR, et al. Efficacy and Safety of Liraglutide Added to Capped Insulin Treatment in Subjects With Type 1 Diabetes: The ADJUNCT TWO Randomized Trial. Diabetes Care. 2016;39(10):1693-1701. doi:10.2337/dc16-0690
37. Shah VN, Peters AL, Umpierrez GE, et al. Consensus Report on Glucagon-Like Peptide-1 Receptor Agonists as Adjunctive Treatment for Individuals With Type 1 Diabetes Using an Automated Insulin Delivery System. J Diabetes Sci Technol. 2025;19(1):191-216. doi:10.1177/19322968241291512
38. Pieber TR, Deller S, Korsatko S, et al. Counter-regulatory hormone responses to hypoglycaemia in people with type 1 diabetes after 4 weeks of treatment with liraglutide adjunct to insulin: a randomized, placebo-controlled, double-blind, crossover trial. Diabetes Obes Metab. 2015;17(8):742-750. doi:10.1111/dom.12473
39. Frandsen CS, Dejgaard TF, Andersen HU, et al. Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia: A randomized, placebo-controlled, double-blind, parallel-group study. Diabetes Obes Metab. 2017;19(6):773-782. doi:10.1111/dom.12830
40. Dejgaard TF, Frandsen CS, Kielgast U, et al. Liraglutide enhances insulin secretion and prolongs the remission period in adults with newly diagnosed type 1 diabetes (the NewLira study): A randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2024;26:4905-4915. doi:10.1111/dom. 15889
41. von Herrath M, Bain SC, Bode B, et al. Anti-interleukin-21 antibody and liraglutide for the preservation of β-cell function in adults with recent-onset type 1 diabetes: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Diabetes Endocrinol. 2021;9(4):212-224. doi:10.1016/S2213-8587(21) 00019-X
42. Madsbad S. Prevalence of residual B cell function and its metabolic consequences in Type 1 (insulin-dependent) diabetes. Diabetologia. 1983;24(3):141-147. doi:10.1007/BF00250151
43. Lachin JM, McGee P, Palmer JP. Impact of C-peptide preservation on metabolic and clinical outcomes in the Diabetes Control and Complications Trial. Diabetes. 2014;63(2):739-748. doi:10.2337/db13-0881
44. Dinneen S, Alzaid A, Turk D, Rizza R. Failure of glucagon suppression contributes to postprandial hyperglycinemia in IDDM. Diabetologia. 1995;38 (3):337-343. doi:10.1007/BF00400639
45. Madsbad S, Hilsted J, Krarup T, et al. Hormonal, metabolic and cardiovascular responses to hypoglycaemia in Type 1 (insulin-dependent) diabetes with and without residual B cell function. Diabetologia. 1982;23(6):499-503. doi:10.1007/BF 00254298
46. Skyler JS. Prevention and reversal of type 1 diabetes--past challenges and future opportunities. Diabetes Care. 2015;38(6):997-1007. doi:10.2337/dc15-0349
47. Zhang J, Tokui Y, Yamagata K, et al. Continuous stimulation of human glucagon-like peptide-1 (7-36) amide in a mouse model (NOD) delays onset of autoimmune type 1 diabetes. Diabetologia. 2007;50(9):1900-1909. doi:10.1007/s00125-007-0737-6
48. Buteau J. GLP-1 receptor signaling: effects on pancreatic beta-cell proliferation and survival. Diabetes Metab. 2008;34 Suppl 2:S73-7. doi:10. 1016/S1262-3636(08)73398-6
49. Buteau J, El-Assaad W, Rhodes CJ, Rosenberg L, Joly E, Prentki M. Glucagon-like peptide-1 prevents beta cell glucolipotoxicity. Diabetologia. 2004;47(5):806-815. doi:10.1007/s00125-004-1379-6
2. Braffett BH, Bebu I, Lorenzi GM, et al. The NIDDK Takes on the Complications of Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study. Diabetes Care. 2025;48(7):1089-1100. doi:10.2337/dc24-2885
3. 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes—2025. Diabetes Care. 2024;48(Supplement_1):S128-S145. doi:10.2337/dc25-S006
4. Bailey R, Calhoun P, Garg SK. Weight Gain and Glycemic Control in Adults with Type 1 Diabetes in the T1D Exchange Registry. Diabetes Technol Ther. 2024;26(3):156-160. doi:10.1089/dia.2023.0389
5. Karakus KE, Akturk HK, Alonso GT, Snell-Bergeon JK, Shah VN. Association Between Diabetes Technology Use and Glycemic Outcomes in Adults With Type 1 Diabetes Over a Decade. Diabetes Care. 2023;46(9):1646-1651. doi:10.2337/dc23-0495
6. Jacobs PG, Levy CJ, Brown SA, et al. Research Gaps, Challenges, and Opportunities in Automated Insulin Delivery Systems. J Diabetes Sci Technol. 2025;19(4): 937-949. doi:10.1177/19322968251338754
7. Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rev. 2007;87(4):1409-1439. doi:10.1152/ physrev.00034.2006
8. Johansen NJ, Dejgaard TF, Lund A, et al. Efficacy and safety of meal-time administration of short-acting exenatide for glycaemic control in type 1 diabetes (MAG1C): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2020;8(4):313-324. doi:10.1016/S2213-8587(20) 30030-9
9. Madsbad S, Holst JJ. Cardiovascular effects of incretins: focus on glucagon-like peptide-1 receptor agonists. Cardiovasc Res. 2023;119(4):886-904. doi:10.1093/cvr/cvac112
10. Madsbad S, Holst JJ. The promise of glucagon-like peptide 1 receptor agonists (GLP-1RA) for the treatment of obesity: a look at phase 2 and 3 pipelines. Expert Opin Investig Drugs. 2025;34(3): 197-215. doi:10.1080/13543784.2025.2472408
11. Xu Y, Echouffo Tcheugui JB, Coresh J, et al. Trends in obesity and glucagon-like peptide-1 receptor agonist prescriptions in type 1 diabetes in the United States. Diabetes Obes Metab. 2025;27(6):2967-2976. doi:10.1111/dom.16300
12. Kilpatrick ES, Rigby AS, Atkin SL. Insulin resistance, the metabolic syndrome, and complication risk in type 1 diabetes: “double diabetes” in the Diabetes Control and Complications Trial. Diabetes Care. 2007;30(3):707-712. doi:10.2337/dc06-1982
13. Pasqua MR, Tsoukas MA, Kobayati A, Aboznadah W, Jafar A, Haidar A. Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial. Nat Med. 2025;31(4):1239-1245. doi:10.1038/s41591-024-03463-z
14. Shah VN, Akturk HK, Kruger D, et al. Semaglutide in Adults with Type 1 Diabetes and Obesity. NEJM evidence. Published online June 2025:EVIDoa2500 173. doi:10.1056/EVIDoa2500173
15. Navodnik MP, Janež A, Žuran I. The Effect of Additional Treatment with Empagliflozin or Semaglutide on Endothelial Function and Arterial Stiffness in Subjects with Type 1 Diabetes Mellitus-ENDIS Study. Pharmaceutics. 2023;15(7). doi:10. 3390/pharmaceutics15071945
16. Dandona P, Chaudhuri A, Ghanim H. Semaglutide in Early Type 1 Diabetes. N Engl J Med. 2023;389 (10):958-959. doi:10.1056/NEJMc2302677
17. Dandona P, Chaudhuri A, Ghanim H. More on Semaglutide in Early Type 1 Diabetes. Reply. N Engl J Med. 2024;390(3):292. doi:10.1056/NEJMc2311 608
18. Grassi BA, Teresa Onetto M, Sánchez C, Tapia N, Mena F. Effect of low dose Semaglutide in people with Type 1 Diabetes and excess weight. Diabetes Res Clin Pract. 2024;209:111593. doi:10.1016/j. diabres.2024.111593
19. Orrange S, Humphrey T, Fayne E, Peters A. Semaglutide for Weight Reduction in Type 1 Diabetes: Promising Results With Uncertain Glycemic Impact. J Diabetes Sci Technol. 2025;19(2):593-594. doi:10.1177/19322968241304779
20. Garg SK, Kaur G, Haider Z, Rodriquez E, Beatson C, Snell-Bergeon J. Efficacy of Semaglutide in Overweight and Obese Patients with Type 1 Diabetes. Diabetes Technol Ther. 2024;26(3):184-189. doi:10.1089/dia.2023.0490
21. Al Hayek A, Klonoff DC, Al Zahrani WM, Ibrahim SE, Al Dawish MA. 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. J Diabetes Complications. 2025;39(7):109064. doi:10.1016/j.jdiacomp.2025.109064
22. Cohen N, Yeung A, Jenkins A. Real-world experience of adjunct weekly semaglutide in Type 1 diabetes. Is it worth it? Diabetes Res Clin Pract. 2025;219:111979. doi:10.1016/j.diabres.2024.111979
23. Almohareb SN, Alfayez OM, Aljuaid SS, et al. Effectiveness and Safety of GLP-1 Receptor Agonists in Patients with Type 1 Diabetes. J Clin Med. 2024;13(21). doi:10.3390/jcm13216532
24. Garg SK, Kaur G, Renner D, et al. Cardiovascular and Renal Biomarkers in Overweight and Obese Adults with Type 1 Diabetes Treated with Tirzepatide for 21 Months. Diabetes Technol Ther. 2025;27(3):152-160. doi:10.1089/dia.2024.0481
25. Garg SK, Akturk HK, Kaur G, Beatson C, Snell-Bergeon J. Efficacy and Safety of Tirzepatide in Overweight and Obese Adult Patients with Type 1 Diabetes. Diabetes Technol Ther. 2024;26(6):367-374. doi:10.1089/dia.2024.0050
26. Karakus KE, Klein MP, Akturk HK, Shah VN. Changes in Basal and Bolus Insulin Requirements with Tirzepatide as an Adjunctive Therapy in Adults with Type 1 Diabetes Using Tandem Control-IQ. Diabetes Ther. 2024;15(7):1647-1655. doi:10.1007/s13300-024-01592-9
27. Akturk HK, Dong F, Snell-Bergeon JK, Karakus KE, Shah VN. Efficacy and Safety of Tirzepatide in Adults With Type 1 Diabetes: A Proof of Concept Observational Study. J Diabetes Sci Technol. Published online February 2024:19322968231223990. doi:10.1177/19322968231223991
28. Rivera Gutierrez R, Tama E, Bechenati D, et al. Effect of Tirzepatide on Body Weight and Diabetes Control in Adults With Type 1 Diabetes and Overweight or Obesity. Mayo Clin Proc. 2025;100(2):265-275. doi:10.1016/j.mayocp.2024.07.006
29. Snell-Bergeon JK, Kaur G, Renner D, Akturk HK, Beatson C, Garg SK. Effectiveness of Semaglutide and Tirzepatide in Overweight and Obese Adults with Type 1 Diabetes. Diabetes Technol Ther. 2025;27(1):1-9. doi:10.1089/dia.2024.0328
30. Bezerra MF, Neves C, Neves JS, Carvalho D. Time in range and complications of diabetes: a cross-sectional analysis of patients with Type 1 diabetes. Diabetol Metab Syndr. 2023;15(1):244. doi:10.1186/s1309 8-023-01219-2
31. Lind M, Svensson AM, Kosiborod M, et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371(21):1972-1982. doi:10. 1056/NEJMoa1408214
32. Perkovic V, Tuttle KR, Rossing P, et al. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024;391(2): 109-121. doi:10.1056/NEJMoa2403347
33. Stougaard EB, Andersen MR, Bagger JI, et al. The Steno 1 study: Multifactorial intervention to reduce cardiovascular disease in type 1 diabetes-rationale and protocol of the prospective, randomized, open-labelled multicentre study. Diabetes Obes Metab. Published online July 2025. doi:10.1111/dom.16606
34. Frampton R, Snaith JR, Hocking S, Holmes-Walker J, Olsen N, Greenfield JR. Reducing cardiometabolic risk with semaglutide in type 1 diabetes (RESET1): Study protocol of a phase 2 double-blinded randomised placebo-controlled trial. Diabet Med. 2024;41(10):e15377. doi:10.1111/dme.15377
35. Mathieu C, Zinman B, Hemmingsson JU, et al. Efficacy and Safety of Liraglutide Added to Insulin Treatment in Type 1 Diabetes: The ADJUNCT ONE Treat-To-Target Randomized Trial. Diabetes Care. 2016;39(10):1702-1710. doi:10.2337/dc16-0691
36. Ahrén B, Hirsch IB, Pieber TR, et al. Efficacy and Safety of Liraglutide Added to Capped Insulin Treatment in Subjects With Type 1 Diabetes: The ADJUNCT TWO Randomized Trial. Diabetes Care. 2016;39(10):1693-1701. doi:10.2337/dc16-0690
37. Shah VN, Peters AL, Umpierrez GE, et al. Consensus Report on Glucagon-Like Peptide-1 Receptor Agonists as Adjunctive Treatment for Individuals With Type 1 Diabetes Using an Automated Insulin Delivery System. J Diabetes Sci Technol. 2025;19(1):191-216. doi:10.1177/19322968241291512
38. Pieber TR, Deller S, Korsatko S, et al. Counter-regulatory hormone responses to hypoglycaemia in people with type 1 diabetes after 4 weeks of treatment with liraglutide adjunct to insulin: a randomized, placebo-controlled, double-blind, crossover trial. Diabetes Obes Metab. 2015;17(8):742-750. doi:10.1111/dom.12473
39. Frandsen CS, Dejgaard TF, Andersen HU, et al. Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia: A randomized, placebo-controlled, double-blind, parallel-group study. Diabetes Obes Metab. 2017;19(6):773-782. doi:10.1111/dom.12830
40. Dejgaard TF, Frandsen CS, Kielgast U, et al. Liraglutide enhances insulin secretion and prolongs the remission period in adults with newly diagnosed type 1 diabetes (the NewLira study): A randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2024;26:4905-4915. doi:10.1111/dom. 15889
41. von Herrath M, Bain SC, Bode B, et al. Anti-interleukin-21 antibody and liraglutide for the preservation of β-cell function in adults with recent-onset type 1 diabetes: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Diabetes Endocrinol. 2021;9(4):212-224. doi:10.1016/S2213-8587(21) 00019-X
42. Madsbad S. Prevalence of residual B cell function and its metabolic consequences in Type 1 (insulin-dependent) diabetes. Diabetologia. 1983;24(3):141-147. doi:10.1007/BF00250151
43. Lachin JM, McGee P, Palmer JP. Impact of C-peptide preservation on metabolic and clinical outcomes in the Diabetes Control and Complications Trial. Diabetes. 2014;63(2):739-748. doi:10.2337/db13-0881
44. Dinneen S, Alzaid A, Turk D, Rizza R. Failure of glucagon suppression contributes to postprandial hyperglycinemia in IDDM. Diabetologia. 1995;38 (3):337-343. doi:10.1007/BF00400639
45. Madsbad S, Hilsted J, Krarup T, et al. Hormonal, metabolic and cardiovascular responses to hypoglycaemia in Type 1 (insulin-dependent) diabetes with and without residual B cell function. Diabetologia. 1982;23(6):499-503. doi:10.1007/BF 00254298
46. Skyler JS. Prevention and reversal of type 1 diabetes--past challenges and future opportunities. Diabetes Care. 2015;38(6):997-1007. doi:10.2337/dc15-0349
47. Zhang J, Tokui Y, Yamagata K, et al. Continuous stimulation of human glucagon-like peptide-1 (7-36) amide in a mouse model (NOD) delays onset of autoimmune type 1 diabetes. Diabetologia. 2007;50(9):1900-1909. doi:10.1007/s00125-007-0737-6
48. Buteau J. GLP-1 receptor signaling: effects on pancreatic beta-cell proliferation and survival. Diabetes Metab. 2008;34 Suppl 2:S73-7. doi:10. 1016/S1262-3636(08)73398-6
49. Buteau J, El-Assaad W, Rhodes CJ, Rosenberg L, Joly E, Prentki M. Glucagon-like peptide-1 prevents beta cell glucolipotoxicity. Diabetologia. 2004;47(5):806-815. doi:10.1007/s00125-004-1379-6