Introduction & Objective: Diabetes is a major public health problem, in 2021, Diabetes affect 537 million adults, and it is estimated to affect 643 million adults by 2030, associated with 6.7 million adult deaths in 2021(1). The Usefulness of Many non-insulin therapies has been investigated in type-1 diabetes like Metformin, and Sodium-Glucose co-transporter-2 inhibitors. Recent evidence on Semaglutide in early Type-1 diabetes shows a promising effect. The study aimed to determine whether Glucagon-Like Peptide-1 Receptor agonist (GLP-1) added to Insulin in Adults with Type-1 Diabetes Mellitus is effective and safe.
Methods: A retrospective cohort was conducted (Jan 2022-Feb 2023) among all adults with Type-1 Diabetes on GLP-1 agonists and overweight/Obesity, attending the Diabetes or Obesity clinic in King Fahad Medical City through an Electronic system records review. Excluding those on other non-insulin Diabetes medications, or obesity interventions. Many variables were evaluated to assess the efficacy and safety: Hga1c, CGM data, Weight, biochemical profile, retinal exam, hypoglycemia, and DKA incidence. Student T test Chi-square and linear mixed modeling were used for statistical analysis.
Result: 32 patients on GLP-1 agonists were recruited, with a mean age of 30 years, 87% were on Semaglutide (0.5mg or 1mg), while the rest were on Liraglutide (1.2mg-3mg), Estimated Hga1c reduction was 0.84% after 8 months from baseline, p-value <0.001. TIR improved by 15% p value <0.001. 31% of the patients achieved 5% TBWL and 12.5% achieved 15% TBWL p-value <0.001. A significant reduction in insulin total daily dose was observed more in bolus insulin. No Significant hypoglycemia, Retinopathy, or DKA episodes.
Conclusions: GLP-1 agonist as adjunctive therapy to insulin shows a significant Improvement in Glycemic control, weight reduction, and insulin requirement in patients with Type-1 diabetes.
K. Habeeb: None. I. Brema: None. M. Almehthel: None. A. Alshehri: None.
