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Diabetes

(22.09) The Efficacy of GLP-1 RA Therapy in Patients with Type 1 Diabetes: A Real-world Observational Study

Saturday, May 11, 2024
12:50 PM – 1:05 PM CDT
Location: ePoster Showcase, Empire Ballroom Foyer, Level 2
Objective : Glucagon-like peptide-1 agonists (GLP-1 RAs) have been proven to be effective in the management of type 2 diabetes mellitus due to the benefits of hemoglobin A1c (HgA1c) reduction, weight loss and potential deintensification of insulin therapy. GLP-1 RAs are underutilized in the treatment of type 1 diabetes mellitus (T1DM), where exogenous insulin remains the mainstay therapy. The aim of our study was to evaluate how the initiation of GLP-1 RAs in individuals with T1DM has effects on HgA1c, weight loss, BMI, total daily insulin (TDI), and time in range (TIR).  

Methods:

We performed a retrospective analysis of nine patients ages 27-73 with T1DM at an endocrinology academic center from 2019 to 2024. Electronic medical records were reviewed for the following data: HgA1c, BMI, weight, TDI, and TIR and were followed within 90 days of initiating GLP-1 RAs. These included exenatide, dulaglutide, and semaglutide. Patients who were using continuous glucose monitoring (CGM) devices and receiving insulin subcutaneously via insulin pens or insulin pumps were included. A paired-samples t-test was conducted to compare the data before and after initiating GLP-1 RAs. For TIR, one patient was excluded due to no reporting of initial TIR in the chart. 

Results: There was a significant decrease in the HgA1c after initiating GLP-1 RAs (M=7.1%, SD=1.0) than before initiating GLP-1 RAs (M=8.0%, SD=1.2); t(8)=-4.16, p=0.001. There was also a significant increase in TIR after initiating GLP-1 RAs (M=71%, SD=13) than before initiating GLP-1 RAs (M=48%, SD=21); t(7)=2.33, p=0.026. There was no significant difference in weight (M=210 lbs, SD=39.1) vs (M=213 lbs, SD=40.6), t(8)= -1.098, p-value=0.15, BMI (M=34.3 kg/m2, SD=6.3) vs (M=35.1 kg/m2, SD=6.3), t(8)=-1.45, p-value=0.092, or TDI (M=95.5 units, SD=90.6) vs (M=102.8, SD=102.1), t(8)=-0.89, p-value=0.20.

Discussion/Conclusion:

Our study showed that adjunctive therapy with GLP-1 RAs in T1DM patients was effective in glycemic control by decreasing HgA1c and increasing TIR. There was no significant change in weight, BMI, or TDI.