Do GLP-1 drugs help as add-ons in type 1 diabetes?

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Across 11 RCTs (2,856 adults), GLP-1 RA add-on therapy modestly lowered HbA1c (−0.21%), weight (−4.04 kg), and insulin doses without more severe hypo/DKA, but GI adverse events rose (OR 2.96).

Source

Glucagon-like peptide-1 receptor agonists as add-on therapy to insulin for type 1 diabetes mellitus

Tan X, Pan X, Wu X, et al. · Frontiers in pharmacology · 2023

doi.org/10.3389/fphar.2023.975880 Read the full paper ↗36 citationscc by

Study at a glance

Design: Meta-analysis / systematic review — Random-effects meta-analysis of RCTs of GLP-1 RAs as add-on to insulin in adult T1D
N: N=2856 · 11 trials; 2,856 participants from 1,379 screened records
Population: Adults with type 1 diabetes on insulin
Outcome: Change in HbA1c plus weight, BP, insulin doses, and selected adverse events

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Searched Medline/Embase/CENTRAL to May 2021 and meta-analyzed randomized trials of GLP-1 receptor agonists added to insulin in adults with type 1 diabetes (primary endpoint: HbA1c change).

What they found

HbA1c −0.21%; weight −4.04 kg; SBP −2.57 and DBP −1.02 mmHg; prandial/basal/total insulin doses decreased. No increase in severe hypoglycemia, DKA, or severe adverse events, but gastrointestinal AEs increased (OR 2.96).

The limits

What it doesn't show

Pooled RCTs cannot settle long-term cardiorenal outcomes or individual agent ranking; GI intolerance may limit real-world uptake.

Key terms

GLP-1 RA: Glucagon-like peptide-1 receptor agonist drug class.
Type 1 diabetes: Autoimmune insulin-deficient diabetes treated primarily with insulin.
HbA1c: Glycated hemoglobin reflecting average glycemia; primary endpoint.
Adjunctive therapy: Add-on medication used alongside insulin.
Diabetic ketoacidosis: Serious insulin-deficiency emergency monitored as a safety endpoint.

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Included RCTs / participants:

Common questions

Trials / N?

11 RCTs; 2,856 participants.

HbA1c change?

−0.21% (95% CI −0.33 to −0.10).

Weight change?

−4.04 kg.

Main safety trade-off?

More gastrointestinal adverse events (OR 2.96).