RESEARCH SUMMARY

GLP-1 Agonists Show Promise for Adolescents, Young Adults with Type 1 Diabetes and Obesity

Anthony Calabro, MA

Key Highlights

  • GLP-1 receptor agonist (GLP1-RA) therapy in adolescents and young adults with type 1 diabetes (T1D) and obesity resulted in significant reductions in BMI and weight.
  • HbA1c improved at 3–5 months post-treatment initiation, with a nonsignificant trend sustained at 6–10 months.
  • No increase in time below range (TBR) or severe hypoglycemia was observed, supporting the safety profile of GLP1-RAs.
  • Non-severe gastrointestinal side effects were self-reported, with no hospitalizations attributed to the therapy.

In a retrospective case series presented at ENDO 2025 in San Francisco, CA, GLP-1 receptor agonist (GLP1-RA) therapy in adolescents and young adults with type 1 diabetes (T1D) and obesity was associated with clinically meaningful reductions in weight and BMI, alongside initial improvements in HbA1c and glycemic control parameters.

At the first follow-up (3–5 months), HbA1c decreased from a baseline of 8.0% to 7.5% (P = .05), BMI was reduced by 4.8% (P = .04), and weight decreased by 4.4% (P = .04). These improvements in anthropometric measures were sustained or enhanced at 6–10 months, with a 6.1% BMI reduction (P = .01) and 5.6% weight reduction (P = .03). No significant increase in hypoglycemia was observed, and the therapy was generally well tolerated.

Although GLP1-RAs are approved for type 2 diabetes and weight management, they are not yet broadly adopted in T1D populations. Emerging adult data show promising results, but evidence in adolescents and young adults remains sparse. Considering the rising prevalence of obesity in T1D, which currently affects approximately 1 in 5 individuals, researchers set out to determine the potential of GLP-1RAs to reduce BMI and support glycemic control in adolescents and young adults with type 1 diabetes and obesity. Indeed, this investigation provides preliminary real-world insights into the efficacy and safety of this adjunct approach.

Researchers identified patients aged 10 to 35 years of age treated with GLP1-RAs between 2014 and 2024 through electronic health records at a large academic hospital system. Inclusion required confirmed T1D diagnosis, insulin dependence, obesity, and at least 3 months of GLP1-RA treatment. Outcomes were measured at baseline and two subsequent time points (3–5 and 6–10 months post-initiation) and included changes in BMI, continuous glucose monitoring (CGM) metrics (time in range and time below range) HbA1c, weight, and total daily insulin dose (TDD). Paired t-tests were used to evaluate changes over time.

Among 24 patients (mean age 19.4 years, 58% female), significant reductions in BMI and weight were observed at both follow-up points. Improvements in HbA1c were statistically significant at the first follow-up but not sustained at the second. Time in range improved from 55% to over 63% by the second follow-up, with no significant increase in time below range. TDD showed a nonsignificant downward trend. Adverse effects were predominantly gastrointestinal and non-severe. One case of diabetic ketoacidosis occurred in a patient with documented insulin nonadherence.

Limitations include the small sample size, retrospective design, incomplete follow-up data, and reliance on documentation from routine clinical encounters, which may underrepresent adverse events or response variability.

“GLP1-RA offers a promising and safe adjunctive therapy for patients with T1D and obesity due to its effects on weight, BMI, and HbA1c,” the study authors concluded.

Reference
Munoz M, Maxwell T, Willi SM, Rickels MR, Katz L. Real world utilization of GLP-1 agonists in adolescents and young adults with type 1 diabetes (T1D) and obesity. Presented at: ENDO 2025; July 12-15, 2025; San Francisco, CA. Abstract presented July 12, 2025.