GLP-1 receptor agonists reduce body mass index and total daily insulin dose in youth with type 1 diabetes: a retrospective cohort study.
Gonzalez. Frances F; Reid. Mark W MW; Garcia. Jaquelin Flores JF; Raymond. Jennifer K JK; Chao. Lily C LC
Key Findings
- ~9.5 kg average weight loss after 12 months (p<0.0001)
- BMI dropped by ~3.7 kg/m² and BMI‑Z score fell by 0.30 (p<0.0001 and p=0.04)
- Total daily insulin dose in pump users fell ~21 % (p=0.002)
- HbA1c fell ~0.8 % after ~16 months (p=0.04)
- CGM time‑in‑range rose ~8 % (trend, p=0.08)
Practical Outcomes
- For people with type‑1 diabetes, adding a GLP‑1RA like semaglutide can be a powerful tool to shed weight and cut insulin needs, which may also improve glucose stability. Start with a low dose and watch for mild GI symptoms. Because the data are from a small, retrospective study, monitor closely and consider it experimental until larger trials confirm safety and dosing guidelines.
Summary
A small study of 24 teens and young adults with type‑1 diabetes and obesity found that taking a GLP‑1 drug (like semaglutide) for about a year led to big weight loss (about 9½ kg), lower BMI, and a big cut in how much insulin they needed, while also nudging blood‑sugar control a bit better. The main side‑effects were short‑lived stomach upset.
Abstract
Youth with type 1 diabetes (T1D) and obesity face challenges in achieving optimal glycemic control and experience higher risk for long-term complications. While glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown weight and glycemic benefits in adults with type 1 diabetes, data in pediatric populations are scarce. We report here changes in glycemia, weight, and insulin doses in youth with T1D and obesity prescribed GLP-1RA. We conducted a single-center retrospective observational study of adolescents and young adults (ages 10-20) with T1D and obesity prescribed GLP-1RA (liraglutide, exenatide, dulaglutide, semaglutide, or tirzepatide) between 2019 and 2024. Data collected included HbA1c, body weight, BMI, total daily insulin dose (TDD), and continuous glucose monitoring (CGM) metrics. Linear mixed effects models assessed changes over time, adjusting for age and gender. Among 24 patients (75 % female, 67 % public insurance, 88 % CGM users, 67 % insulin pump users), 12 months of GLP-1RA treatment led to significant reductions in weight (-9.49 kg, p<0.0001), BMI (-3.69 kg/m<sup>2</sup>, p<0.0001), and BMI Z-score (-0.30, p=0.04). CGM time-in-range increased by +7.96 % (p=0.08), and time above range (180-250 mg/dL) decreased by -3.04 % (p=0.06). TDD among pump users declined by -21.42 % (p=0.002). After approximately 16 months, HbA1c decreased by -0.81 % (p=0.04). Side effects were mainly gastrointestinal and transient. This first longitudinal report of GLP-1RA use in youth with T1D and obesity shows clinically meaningful improvements in weight, glycemia, and insulin requirements, supporting the potential role of GLP-1RA as adjunct therapy. Larger prospective studies are needed to guide clinical practice.
Study Information
pubmed
2025
2025-12-08T00:00:00.000Z
10.1515/jpem-2025-0568