Daily Glucagon-like Peptide-1 Receptor Agonists in Type 1 Diabetes: What we've Learned and What Comes Next.

Rachael Innes, John R Petrie, Thomas Fremming Dejgaard

Journal: Endocrinology and metabolism clinics of North America 2026;55(3):421-435

PMID: 42526994

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Abstract

Phase 2 clinical trials using daily injectable glucagon-like peptide-1 receptor agonists as adjunct therapy in type 1 diabetes showed promising signals for efficacy on glycemic control and weight. These effects were confirmed in larger phase 3 trials but accompanied by safety issues including hypoglycemia and ketosis. Of note, these trials were conducted before the availability of widespread continuous glucose monitoring (CGM) and used simple one size fits all rules for insulin dose titration. Attention has moved on to weekly injectable agents at present, with more individualized insulin titration and guided by CGM.

Address: School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.; School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Robertson Centre for Biostatistics/ Glasgow Clinical Trials Unit, University of Glasgow, Glasgow, UK.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology and Nephrology, Nordsjællands Hospital - Hillerød, Hillerød, Denmark. Electronic address: [email protected].

DOI: 10.1016/j.ecl.2026.04.002

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MeSH Terms: Humans, Diabetes Mellitus, Type 1, Glucagon-Like Peptide-1 Receptor Agonists, Hypoglycemic Agents, Continuous Glucose Monitoring, Glucagon-Like Peptide-1 Receptor, Peptides