Glucagon-like Peptide-1 Receptor Agonist Treatment With Semaglutide in Type 1 Diabetes

Lisa M Raven; Jerry R Greenfield; Christopher A Muir

doi:10.1210/jcemcr/luac017

Glucagon-like Peptide-1 Receptor Agonist Treatment With Semaglutide in Type 1 Diabetes

JCEM Case Rep. 2022 Nov 30;1(1):luac017. doi: 10.1210/jcemcr/luac017. eCollection 2023 Jan.

Authors

Lisa M Raven^{1

2

3}, Jerry R Greenfield^{1

2

3}, Christopher A Muir^{1

2}

Affiliations

¹ Department of Diabetes and Endocrinology, St. Vincent's Hospital, Darlinghurst, NSW 2010, Australia.
² School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia.
³ Clinical Diabetes, Appetite and Metabolism Laboratory, Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia.

Abstract

The efficacy of glucagon-like peptide-1 receptor agonists in type 2 diabetes is well established, but their role in type 1 diabetes (T1DM) is less clear. A 36-year-old woman with a 27-year history of T1DM and undetectable c-peptide presented for review of weight management, with body mass index 29.3 kg/m². A previous trial of dapagliflozin led to no improvement in weight or glycemic control. Semaglutide was introduced (0.25 mg weekly increased to 0.5 mg weekly) and was well tolerated. After 6 months, weight had decreased by 16 kg and insulin dose by 36%. Despite less insulin, hemoglobin A1c improved, with reduced glycemic variability and no increase in hypoglycemia. Semaglutide may exert significant metabolic benefits in patients with established T1DM, even where c-peptide is no longer detectable. This case supports the need for a dedicated trial examining potential benefits of semaglutide in T1DM.

Keywords: GLP-1; glucagon-like peptide-1 receptor agonist; semaglutide; type 1 diabetes.

Publication types

Case Reports