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Cited by 68Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes and associated disorders

Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial

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Pasqua, Melissa-Rosina, Tsoukas, Michael A., Kobayati, Alessandra, Aboznadah, Wedyan, Jafar, Adnan, Haidar, Ahmad·2025·Nature Medicine
DOI 10.1038/s41591-024-03463-zPMC PMC12003151
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Abstract

Efforts to improve glycemic control in type 1 diabetes are ongoing. We performed a randomized, double-blind, crossover trial to assess semaglutide as adjunct to automated insulin delivery therapy in adults with type 1 diabetes. At each intervention, participants were titrated up to 1 mg or the maximum tolerated dose of semaglutide or placebo over 11 weeks, followed by the use of an automated insulin delivery system for 4 weeks. The primary outcome was the percentage of time spent in the target glucose range of 3.9–10.0 mmol l−1 during the last 4 weeks of each intervention. Twenty-eight participants were randomized and 24 completed the trial. The primary endpoint was met. Compared to placebo, semaglutide increased time in the target range by a mean 4.8 (s.d. = 7.6) percentage points (P = 0.006), without increasing the time spent below 3.9 mmol l−1 (P = 0.19) or below 3.0 mmol l−1 (P = 0.65). While no diabetic ketoacidosis or severe hypoglycemia occurred during any of the interventions, there were two episodes of recurrent euglycemic ketosis without acidosis during semaglutide use. We conclude that semaglutide improves glycemic control with automated insulin delivery compared to placebo. ClinicalTrials.gov registration: NCT05205928 In a crossover trial evaluating semaglutide versus placebo as an add-on to automated insulin delivery therapy in adults with type 1 diabetes, the use of semaglutide was associated with an increased percentage of time spent within the target glucose range, along with reduced insulin requirements.

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  • GLP-1 receptor agonists reduce bodyweight and insulin dose, with modest improvements in glycaemic control.

    “GLP1 receptor agonists reduce bodyweight and insulin dose, with modest improvements in glycaemic control.[93][94][95][96]”

    From The future of type 1 diabetes therapy (2025) · cites this paper as [96]

    The Discussion reports that semaglutide reduced body weight and insulin requirements and improved glycaemic control in adults with type 1 diabetes using automated insulin delivery. The claim generalizes those findings to GLP-1 receptor agonists as a class; this trial directly tested only semaglutide in that specific setting. (LLM, conf=0.84)

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References 48 · Cited by 68

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Authors
Pasqua, M.-R., Tsoukas, M. A., Kobayati, A., Aboznadah, W., Jafar, A., & Haidar, A.
Affiliations
  • McGill University Health Centre (CA)
  • King Abdulaziz University (SA)
  • McGill University (CA)
Corresponding author
  • Pasqua, Melissa-Rosina
  • Haidar, Ahmad
ORCID
Venue
Nature Medicine
Publisher
Springer Science and Business Media LLC
Published
2025-01-10
Volume
31
Issue
4
Pages
1239-1245
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
DOI
10.1038/s41591-024-03463-z
PMC
PMC12003151
OpenAlex
W4406231961
Cited by
68
References
48
Citations by year
2026: 37 · 2025: 31
FWCI
46.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
Canada Research Chair for Artificial Pancreas Systems.
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords
semaglutide, type 1 diabetes, artificial pancreas, glycemic control, time in target glucose range, GLP-1 receptor agonists, insulin requirement, hypoglycemia, diabetic ketoacidosis
MeSH terms
Semaglutide, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Double-Blind Method, Glucagon-Like Peptides, Female, Humans, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Insulin Infusion Systems, Male, Middle Aged, Treatment Outcome, Cross-Over Studies, Glucagon-Like Peptide 1, Young Adult

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