Oral Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

An observational study on the use of semaglutide in type 1 diabetes (129209)

Purnima (Darshi) Cheruvu 1 , Matilda Longfield 1 2 , Natassia Rodrigo 1 2 3 , Sarah Glastras 1 2 4
  1. Endocrinology, Diabetes and Metabolism, Royal North Shore Hospital, Sydney, NSW, Australia
  2. Kolling Institute, University of Sydney, Sydney, NSW, Australia
  3. Department of Endocrinology, Nepean Hospital, Sydney, NSW, Australia
  4. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

Obesity and being overweight are common in patients with type 1 diabetes mellitus (T1DM), which contributes to multiple cardiometabolic complications (1,2). Adjunct therapies used in type 2 diabetes, including GLP-1 receptor agonists, have shown promise in T1DM (3). Limited data exist on the specific impact of semaglutide in this population (1,2). The aim of this study was to examine the effect of semaglutide use on glycaemic control as measured by HbA1c and time in range [blood glucose level 3.9-10 mmol/L] on continuous glucose monitoring (CGM), body weight and body mass index (BMI).

We conducted a retrospective review of medical records from patients with T1DM treated with semaglutide for a minimum of 3 months during endocrinology consultations at Royal North Shore Hospital. Patient age, duration of diabetes, HbA1c, weight, BMI, BP and fasting lipid profile within 3 months prior to semaglutide initiation and within 3 months after date of follow up were collected. CGM metrics from two weeks before semaglutide initiation and before the follow-up appointment were analysed.

23 individuals were included, with mean age 50 +/- 14 years, weight 92.1 +/- 14.4kg, BMI 33.7 +/- 5.2 kg/m2, HbA1c 8.1 +/- 1.3% and SBP 132 +/- 12.1mmHg, with mean duration of semaglutide use 204.7 +/- 107.1 days. Semaglutide was associated with a significant reduction in body weight (mean change 6.72 +/- SE 4.4kg), BMI (mean change 2.5 +/- SE 1.6), HbA1c (mean change 0.53 +/- SE 0.36), and systolic blood pressure (12.5 +/- SE 3.6 mmHg) sustained for over six months. CGM data showed a reduction in time spent above range. There was a reduction in total cholesterol and LDL-C. No severe hypoglycaemia, diabetic ketoacidosis (DKA) or hospital admissions were reported.

Semaglutide was safe and effective in patients with T1DM and obesity, improving glycaemic control and cardiometabolic markers without increased complications.

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  2. 2. Pasqua M-R, 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. Nature Medicine. 2025;31(4):1239-45.
  3. 3. Rodbard HW, Lingvay I, Reed J, de la Rosa R, Rose L, Sugimoto D, et al. Semaglutide Added to Basal Insulin in Type 2 Diabetes (SUSTAIN 5): A Randomized, Controlled Trial. J Clin Endocrinol Metab. 2018;103(6):2291-301.