A double-blind, randomized crossover trial found that subcutaneous semaglutide significantly improved glycemic control in adults with type 1 diabetes using automated insulin delivery therapy.
The trial included 28 participants (79% using commercial automated insulin delivery (AID) systems), with 24 completing the intervention. Participants received semaglutide titrated up to 1 mg or their highest tolerated dose over 11 weeks, followed by four weeks of AID use. Compared to placebo, semaglutide increased the percentage of time in the target glucose range (3.9–10.0 mmol/L) by a mean of 4.8 percentage points (SD, 7.6; P = .006).
The study,published in Nature Medicine, found no significant increase in time spent below 3.9 mmol/L (P = .19) or 3.0 mmol/L (P = .65). Secondary outcomes showed significant improvements, including:
- Weight reduction of 5.3 kg (SD, 2.9) versus placebo (P < .001)
- Daily insulin reduction of 11.3 units
- HbA1c reduction of 0.5%
"While no diabetic ketoacidosis or severe hypoglycemia occurred during any of the interventions, there were two episodes of recurrent euglycemic ketosis without acidosis during semaglutide use," said Melissa-Rosina Pasqua, PhD, of the Division of Endocrinology & Metabolism, McGill University Health Centre, Montréal, Quebec, Canada.
"We conclude that semaglutide improves glycemic control with automated insulin delivery compared to placebo." These findings underscore semaglutide's potential as an effective adjunct to AID therapy for type 1 diabetes management, though further research is warranted.
Disclosures: Dr. Pasqua reported receiving speaker honoraria from Medtronic Diabetes Canada and Abbott Diabetes Care. Other authors reported consulting relationships and support from multiple pharmaceutical companies.