A recent study published in Nature Medicine examined the benefits of combining semaglutide, a GLP-1 receptor agonist, with automated insulin delivery (AID) systems for improving glycemic control in patients with type 1 diabetes (T1D). This randomized, double-blind, crossover trial revealed promising results, showing that semaglutide can significantly reduce insulin requirements while improving glucose control and contributing to weight loss.
The study, conducted at the Research Institute of the McGill University Health Centre, involved 113 adults with T1D. Participants, who had been using insulin pumps for at least three months, were given weekly subcutaneous doses of semaglutide over 32 weeks. The trial compared the effects of semaglutide combined with AID against a placebo.
AID, the most advanced form of insulin therapy for T1D, works by continuously monitoring glucose levels and adjusting insulin delivery via an algorithm. Previous studies have shown AID’s effectiveness in reducing HbA1c levels, but challenges remain in achieving optimal glucose control, particularly after meals. Semaglutide, which has shown benefits in type 2 diabetes management, was tested to see if it could enhance the effectiveness of AID.
The results were promising. Participants who received semaglutide experienced significant reductions in HbA1c and lower insulin requirements compared to those who received a placebo. The treatment also led to a reduction in body weight, BMI, and waist circumference, with greater glycemic benefits observed in participants who lost more weight. However, the study did not observe significant changes in blood pressure or other non-glycemic outcomes, likely due to the baseline health status of participants.
Adverse events were mostly gastrointestinal, with some participants experiencing mild issues such as euglycemic ketosis. One participant on the placebo group experienced severe hypoglycemia due to a malfunction in the continuous glucose monitor.
This study suggests that semaglutide, when used as an adjunct to AID, can help patients with T1D achieve better glycemic control while reducing insulin dependency. However, researchers caution that long-term studies are needed to fully assess the safety and efficacy of this combination therapy in a larger, more diverse cohort.
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