Effectiveness of Semaglutide and Tirzepatide in Overweight and Obese Adults with Type 1 Diabetes
Open accessAbstract
Objective: Adults with type 1 diabetes (T1D) are increasingly overweight or obese, in part due to intensive insulin therapy. Newer non-insulin medications targeting both hyperglycemia and weight loss are approved for people with type 2 diabetes. These drugs also reduce cardiovascular disease, the major cause of mortality in people with diabetes. We assessed the real-world use of semaglutide and tirzepatide, in adults with T1D followed in a specialty diabetes clinic. Materials and Methods: This retrospective chart review included 100 adults who were prescribed semaglutide or tirzepatide (50 each) and 50 controls frequency matched for age, sex, diabetes duration, body mass index, and glycosylated hemoglobin (HbA1c) and who did not receive any weight loss medications during the study period. Data were collected prior to initiation of weight loss medications (baseline) and then for up to 1 year for each patient. Results: Matching characteristics did not differ between cases and controls. There were declines in weight in both semaglutide (−19.2 ± standard error (SE) 2.9 lbs. [9.1% body weight lost]) and tirzepatide (−49.4 ± SE 3.0 lbs. [21.4% body weight lost]) groups, and HbA1c decreased in both semaglutide (−0.54 ± SE 0.14%, P = 0.0001) and tirzepatide users (−0.68 ± SE 0.16%, P < 0.0001) over 12 months. Weight and HbA1c didn’t change in controls. Conclusions: We observed weight loss of 9.1% and 21.4% and improved glucose control in semaglutide and tirzepatide users, respectively, after 1 year of off-label use. As off-label use of these drugs is increasing in patients with T1D, larger, prospective safety and efficacy trials are needed.
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Claims the paper makes
12 of 23 cited sources checked · 4 supported · 1 flagged · accuracy not yet measured
- Premisecitation
In a recent analysis including 16 million patients in a claims database, the incidence of GI complications increased among users of GLP-1 agonists.
“In a recent analysis including 16 million patients in a claims database, the incidence of GI complications increased among users of GLP-1 agonists.39”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [39] 39. Kolkailah AA, Lingvay I, Dobrecky-Mery I, et al. Effects of once-weekly subcutaneous semaglutide on coronary artery disease outcomes in patients with type 2 diabetes with or at high risk for cardiovascular disease: Insights from the SUSTAIN-6 trial. Diabetes Obes Metab 2023;25(4): 1117-1120; doi: 10.1111/dom.14941 source
The Background and Results describe a post-hoc analysis of a randomized SUSTAIN-6 trial involving 3,297 patients, not an analysis of 16 million patients in a claims database. The reported outcomes are coronary events; the cited paper does not report increased gastrointestinal complications. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured
- Premisecitation
Data from the SELECT cardiovascular outcomes trial of semaglutide in overweight and obese patients without diabetes demonstrated sustained weight loss for up to 4 years while continuing the medication.
“but data from the SELECT cardiovascular outcomes trial of semaglutide in OW and OB patients without diabetes demonstrated sustained weight loss for up to 4 years while continuing the medication.27”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [27] 27. Ahrén B, Atkin SL, Charpentier G, et al. Semaglutide indu- ces weight loss in subjects with type 2 diabetes regardless of baseline BMI or gastrointestinal adverse events in the SUSTAIN 1 to 5 trials. Diabetes Obes Metab 2018;20(9): 2210-2219; doi: 10.1111/dom.13353 source
The Results report semaglutide-associated weight loss, but the Methods (Study design; Study endpoints and assessments, page not provided) identify the data as coming from SUSTAIN 1–5 trials in people with type 2 diabetes, measured over 30 or 56 weeks. The paper does not support the attributed SELECT-trial finding in people without diabetes or sustained weight loss for up to four years. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Findingown data
Weight loss was significantly greater among tirzepatide users than semaglutide users, regardless of insulin delivery method.
“Weight loss was significantly greater among tirzepatide users than semaglutide users, regardless of insulin delivery method.”
Quote in the paperSubstantial claim - Findingown data
There was a trend toward greater weight loss among insulin pump/AID users than those using MDI among both semaglutide and tirzepatide users.
“Change in BMI and weight did not differ significantly by insulin delivery method, though there was a trend toward greater weight loss among insulin pump/AID users than those using MDI among both semaglutide and tirzepatide users.”
Quote in the paperNot a substantial claim - Findingnone given
Most patients in the study did not reach the 1 or 2 mg dose of semaglutide or the 15 mg dose of tirzepatide as recommended for patients with type 2 diabetes.
“Most of the patients in this study did not reach the 1 or 2 mg dose of semaglutide or the 15 mg dose of tirzepatide as recommended for patients with T2D.”
Quote in the paperNot a substantial claim
- Findingown data
Three semaglutide users and one tirzepatide user discontinued the medication due to lack of response.
“After beginning the medication, three semaglutide users and one tirzepatide user discontinued the medication due to lack of response.”
Quote in the paperNot a substantial claim - Findingown data
Body weight decreased by 49.4 lbs (21.4%) at 12 months in the tirzepatide group.
“tirzepatide (-49.4 -SE 3.0 lbs.[21.4% body weight lost])”
- Also stated in: § Change in BMI and body weight · plain
“by 49.4 -3.0 lbs.(21.4%)”
- Also stated in: § Discussion · plain
“lost >49 lbs.(21.4%)”
Quote in the paperSubstantial claim - Also stated in: § Change in BMI and body weight · plain
- Findingcitation
No hospitalizations from severe hypoglycemia or diabetic ketoacidosis were reported in the medical records for these patients.
“As previously reported, there were no reported hospitalizations from severe hypoglycemia or diabetic ketoacidosis (DKA) noted in the medical record for these patients.36,37”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [36] 36. Garg SK, Akturk HK, Kaur G, et al. Efficacy and safety of tirzepatide in overweight and obese adult patients with type 1 diabetes. Diabetes Technol Ther 2024;26(6):367-374; doi: 10.1089/dia.2024.0050 source
- cites [37] 37. Harris E. EHR data suggest tirzepatide outdoes semaglutide for weight loss. JAMA 2024;332(8):610; doi: 10.1001/jama .2024.13770 source
- Findingown data
HbA1c did not change in controls over 12 months.
“Weight and HbA1c didn't change in controls.”
- Also stated in: § Change in HbA1c · plain
“with no change in HbA1c among controls (-0.04 -0.13%, -0.4 mmol/mol)”
Quote in the paperSubstantial claim - Also stated in: § Change in HbA1c · plain
- Findingown data
The median dose of semaglutide given was 0.5 mg weekly.
“The median dose of semaglutide given was 0.5 mg weekly, and the median dose of tirzepatide given was 7.5 mg weekly (Table 1).”
- Also stated in: § Discussion · plain
“on a median semaglutide dose of 0.5 mg weekly.”
Quote in the paperNot a substantial claim - Also stated in: § Discussion · plain
- Findingown data
The decrease in HbA1c was significantly greater in semaglutide users than controls (P = 0.006) overall.
“The decrease in HbA1c was significantly greater in semaglutide users than controls (P = 0.006) and in tirzepatide users compared with controls (P < 0.0001) overall (Fig. 2D).”
Quote in the paperSubstantial claim - Findingown data
The change in daily insulin dose per kilogram of body weight was not significantly different from zero in either the control group or semaglutide groups at any time point.
“The change in daily insulin dose per kilogram of body weight was also significantly different from zero at all time points in the tirzepatide group but was not significantly different from zero in either the control group or semaglutide groups at any time point.”
Quote in the paperSubstantial claim - Findingown data
HbA1c was lower in tirzepatide users than in semaglutide users at baseline.
“TDD and basal daily insulin dose were higher in the tirzepatide group than the control group, and HbA1c was lower in tirzepatide users than in semaglutide users (Table 1).”
Quote in the paperNot a substantial claim - Findingown data
Weight did not change in controls over 12 months.
“Weight and HbA1c didn't change in controls.”
Quote in the paperSubstantial claim - Findingown data
HbA1c decreased by 0.68% (7.4 mmol/mol) at 12 months in tirzepatide users.
“tirzepatide users (-0.68 -SE 0.16%, P < 0.0001)”
- Also stated in: § Change in HbA1c · plain
“a decrease in the least square mean -SE HbA1c of 0.68 -0.16% (7.4 mmol/mol) in the tirzepatide users”
- Also stated in: § Discussion · plain
“0.68%”
Quote in the paperSubstantial claim - Also stated in: § Change in HbA1c · plain
- Findingown data
There were no significant changes in BMI in the control group at any time point.
“There were no significant changes in BMI in the control group at any of the time points (Fig. 2A).”
Quote in the paperNot a substantial claim - Findingown data
The decrease in HbA1c was significantly greater in tirzepatide users compared with controls (P < 0.0001) overall.
“The decrease in HbA1c was significantly greater in semaglutide users than controls (P = 0.006) and in tirzepatide users compared with controls (P < 0.0001) overall (Fig. 2D).”
Quote in the paperSubstantial claim - Findingown data
BMI decreased by 7.5 kg/m2 at 12 months in the tirzepatide group.
“BMI decreased by a least square mean -SE of 3.0 -0.5 kg/m 2 and 7.5 -0.5 kg/m 2 at 12 months in the semaglutide and tirzepatide groups, respectively.”
- Also stated in: § Discussion · plain
“with a decrease in BMI of 7.5 kg/m 2 at 1 year”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
Total daily insulin dose and basal and bolus insulin doses decreased to a greater extent in the tirzepatide group than in controls and semaglutide users at all time points.
“TDD and basal and bolus insulin doses decreased to a greater extent in the tirzepatide group than in controls and semaglutide users at all time points, but only bolus insulin dose at 6 months differed between semaglutide users and controls (Table 2).”
Quote in the paperSubstantial claim - Findingown data
At 6 months, there was a greater decrease in HbA1c in tirzepatide users than in semaglutide users.
“There was no difference in the amount of decrease in HbA1c between semaglutide and tirzepatide users overall (P = 0.175), but at 6 months, there was a greater decrease in tirzepatide users than in semaglutide users (Fig. 2D).”
Quote in the paperNot a substantial claim - Findingown data
There was no difference in the amount of decrease in HbA1c between semaglutide and tirzepatide users overall (P = 0.175).
“There was no difference in the amount of decrease in HbA1c between semaglutide and tirzepatide users overall (P = 0.175), but at 6 months, there was a greater decrease in tirzepatide users than in semaglutide users (Fig. 2D).”
- Also stated in: § Discussion · plain
“no significant difference in the HbA1c decrease achieved by semaglutide (-0.54%) versus tirzepatide (-0.68%) users.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
All patients on an insulin pump were on an automated insulin delivery (AID) system.
“All patients on an insulin pump were on an AID system, as noted in Table 1.”
- Also stated in: § Discussion · plain
“though of note all patients in the analysis who were using insulin pumps were on AID systems.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
BMI decreased by 3.0 kg/m2 at 12 months in the semaglutide group.
“BMI decreased by a least square mean -SE of 3.0 -0.5 kg/m 2 and 7.5 -0.5 kg/m 2 at 12 months in the semaglutide and tirzepatide groups, respectively.”
- Also stated in: § Discussion · plain
“had a decrease in BMI of 3.0 kg/m 2 at 1 year”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
Change in BMI and weight did not differ significantly by insulin delivery method.
“Change in BMI and weight did not differ significantly by insulin delivery method, though there was a trend toward greater weight loss among insulin pump/AID users than those using MDI among both semaglutide and tirzepatide users.”
- Also stated in: § Discussion · plain
“There was no difference in weight loss between the group who received insulin via MDI or insulin pump/AID.”
Quote in the paperNot a substantial claim - Also stated in: § Discussion · plain
- Findingown data
Among tirzepatide users who completed 12 months of treatment, the median dose was 10 mg weekly.
“on a median tirzepatide dose (for those who completed 12 months of treatment) of 10 mg weekly.”
Quote in the paperNot a substantial claim - Findingown data
Only bolus insulin dose at 6 months differed between semaglutide users and controls.
“TDD and basal and bolus insulin doses decreased to a greater extent in the tirzepatide group than in controls and semaglutide users at all time points, but only bolus insulin dose at 6 months differed between semaglutide users and controls (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
HbA1c decreased by 0.54% (5.9 mmol/mol) at 12 months in semaglutide users.
“HbA1c decreased in both semaglutide (-0.54 -SE 0.14%, P = 0.0001)”
- Also stated in: § Change in HbA1c · plain
“There was a significant decrease in the least square mean -SE HbA1c of 0.54 -0.14% (5.9 mmol/mol) in semaglutide users”
- Also stated in: § Discussion · plain
“with a decrease of 0.54%”
Quote in the paperSubstantial claim - Also stated in: § Change in HbA1c · plain
- Findingown data
The change in daily insulin dose per kilogram of body weight was significantly different from zero at all time points in the tirzepatide group.
“The change in daily insulin dose per kilogram of body weight was also significantly different from zero at all time points in the tirzepatide group but was not significantly different from zero in either the control group or semaglutide groups at any time point.”
Quote in the paperSubstantial claim - Findingown data
There was a greater change in total daily insulin dose per kilogram in tirzepatide users than in controls and semaglutide users at all time points.
“There was a greater change in total daily insulin dose per kilogram in tirzepatide users than in controls and semaglutide users at all time points (Table 2).”
Quote in the paperSubstantial claim - Findingown data
Body weight decreased by 19.2 lbs (9.1%) at 12 months in the semaglutide group.
“There were declines in weight in both semaglutide (-19.2standarderror (SE) 2.9 lbs.[9.1% body weight lost])”
- Also stated in: § Change in BMI and body weight · plain
“body weight decreased by a least square mean -SE of 19.2 -3.0 lbs.(9.1%)”
- Also stated in: § Discussion · plain
“lost a significant amount of weight (>19 lbs., 9.1% of body weight)”
Quote in the paperSubstantial claim - Also stated in: § Change in BMI and body weight · plain
- Premisecitation
The only FDA-approved treatments for type 1 diabetes are insulin and pramlintide.
“The only Food and Drug Administration (FDA)-approved treatments for T1D are insulin and pramlintide 25 ; the latter is rarely used due to gastrointestinal (GI) side effects and risk for severe hypoglycemia.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [25] 25. de Melo MB, Daldegan-Bueno D, Menezes Oliveira MG, et al. Beyond ANOVA and MANOVA for repeated meas- ures: Advantages of generalized estimated equations and generalized linear mixed models and its use in neuroscience research. Eur J Neurosci 2022;56(12):6089-6098; doi: 10 .1111/ejn.15858 source
- Interpretationown data
These results suggest that these therapies could further improve glycemic control in adults with type 1 diabetes who are already using AID systems.
“These results suggest that these therapies could further improve glycemic control on adults with T1D who are already using AID systems.”
- Also stated in: § Conclusions · hedged
“Furthermore, there was improvement in HbA1c among patients already using an AID, suggesting that these two treatments could be combined to achieve optimal glycemic control in more adults with T1D.”
Quote in the paperSubstantial claim - Also stated in: § Conclusions · hedged
- Study design and conductown data
The study used real-world use of anti-obesity drugs in overweight and obese patients with type 1 diabetes.
“The strengths of our article include real-world use of anti-OB drugs in OW and OB patients with T1D, follow-up for up to 1 year, frequency matched controls with a similar BMI followed during the same time period and with similar rates of commercial insurance, assessment of glucose control (HbA1c) throughout the study period, and insulin dose information.”
Quote in the paperSubstantial claim - Study design and conductnone given
The study had a small sample size.
“The weaknesses are retrospective chart review, small sample size, lack of information regarding titration schedule used and side effects experienced, off-label use of these medications in patients with T1D, and lack of data from diverse populations (*85% of subjects were non-Hispanic White, all seen at a specialty diabetes clinic).”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 15
- May combine two claims. 23
Classified as probably not a substantial claim.
PremisecitationMore than 62% of adults with type 1 diabetes in the United States are either overweight (34%) or obese (28%).
“More than 62% of adults with T1D in the United States are either OW (34%) or OB (28%), similar to the 64% of adults without diabetes who are OW (36%) or OB (28%) although lower than the 86% of adults with type 2 diabetes (T2D) who are OW (34%) or OB (52%).19”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [19] 19. Marso SP, Bain SC, Consoli A, et al. SUSTAIN-6 Investiga- tors. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016;375(19):1834-1844; doi: 10.1056/NEJMoa1607141 source
The Patients section describes a trial of people with type 2 diabetes and reports their mean body weight, not U.S. overweight or obesity prevalence. Searches for the 62%, 34%, and 28% figures and for the comparisons with adults without diabetes and with type 2 diabetes found no supporting passage in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationIn people with type 1 diabetes, intensive insulin therapy reduces the risk of both microvascular and macrovascular complications.
“The landmark Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications studies have demonstrated that intensive insulin therapy reduces the risk of both micro-and macro-vascular complications in people with T1D.1,2”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites [1] 1. Diabetes Control and Complications Trial (DCCT)/Epi- demiology of Diabetes Interventions and Complications (EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: The DCCT/EDIC study 30-year follow-up. Diabetes Care 2016; 39(5):686-693; doi: 10.2337/dc15-1990 source
- cites [2] 2. Nathan DM, Genuth S, Lachin J, et al. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329(14):977-986; doi: 10 .1056/NEJM199309303291401 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationNewer therapeutic agents including GLP-1 receptor agonists and GIP plus GLP dual agonists may decrease cardiovascular disease and diabetic kidney disease.
“In addition, these newer therapeutic agents may decrease cardiovascular disease (CVD) 20 and diabetic kidney disease (DKD), 21 the major life-shortening complications of diabetes.[22][23][24]”
Quote in the paperNot a substantial claim3 of 5 sources checked- cites [20] 20. Granata A, Maccarrone R, Anzaldi M, et al. GLP-1 receptor agonists and renal outcomes in patients with diabetes melli- tus type 2 and diabetic kidney disease: State of the art. Clin Kidney J 2022;15(9):1657-1665; doi: 10.1093/ckj/sfac069 source
The Introduction reports that GLP-1 receptor agonists reduce major adverse cardiovascular events and slow the progression of renal damage in people with type 2 diabetes. The paper does not establish the same benefit for GIP/GLP-1 dual agonists; its discussion of GIP concerns incretin physiology, not outcomes with dual agonists. No page numbers are available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [21] 21. Lim AK. Diabetic nephropathy-complications and treat- ment. Int J Nephrol Renovasc Dis 2014;7:361-381; doi: 10 .2147/IJNRD.S40172
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [22] 22. Abi Khalil C, Roussel R, Mohammedi K, et al. Cause-spe- cific mortality in diabetes: Recent changes in trend mortal- ity. Eur J Prev Cardiol 2012;19(3):374-381. source
- cites [23] 23. Buscemi J, Saiyed N, Silva A, et al. Diabetes mortality across the 30 biggest U.S. cities: Assessing overall trends and racial inequities. Diabetes Res Clin Pract 2021;173: 108652; doi: 10.1016/j.diabres.2021.108652 source
- cites [24] 24. Galderisi A, Sherr J, VanName M, et al. Pramlintide but not liraglutide suppresses meal-stimulated glucagon responses in type 1 diabetes. J Clin Endocrinol Metab 2018;103(3): 1088-1094; doi: 10.1210/jc.2017-02265 source
The Introduction discusses postprandial glucose control and the risk of complications, but does not say these agents reduce cardiovascular disease or diabetic kidney disease. The Results address meal-stimulated glucose and glucagon responses in type 1 diabetes. Searches for cardiovascular, kidney, and renal outcomes found no passage supporting the attributed claim; our copy is not truncated. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationTirzepatide is a twincretin (GIP + GLP), with its predominant effects on glycemic control and weight loss, compared with semaglutide, which is a GLP-1 receptor agonist only.
“Tirzepatide is a twincretin (GIP + GLP), with its predominant effects on glycemic control and weight loss, 30 compared with semaglutide, which is a GLP-1 receptor agonist only.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [30] 30. Osumili B, Fan L, Paik JS, et al. Tirzepatide 5, 10 and 15 mg versus injectable semaglutide 0.5 mg for the treatment of type 2 diabetes: An adjusted indirect treatment compari- son. Diabetes Res Clin Pract 2024;212:111717; doi: 10 .1016/j.diabres.2024.111717 source
May combine two claims.
InterpretationcitationBased on data from the SUSTAIN-6 and SELECT trials showing reduced cardiovascular disease in people with type 2 diabetes and in overweight/obese people without diabetes, it is likely that patients with type 1 diabetes would benefit from use of these novel agents not only for weight loss and improved glycemic control but also due to anticipated reductions in cardiovascular disease and diabetic keto
“In addition, based on data from the SUSTAIN-6 and SELECT trials showing reduced CVD in people with T2D and in OW/OB people without diabetes, 20,40 it is likely that patients with T1D would benefit from use of these novel agents not only for weight loss and improved glycemic control but also due to anticipated reductions in CVD and DKD.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [20] 20. Granata A, Maccarrone R, Anzaldi M, et al. GLP-1 receptor agonists and renal outcomes in patients with diabetes melli- tus type 2 and diabetic kidney disease: State of the art. Clin Kidney J 2022;15(9):1657-1665; doi: 10.1093/ckj/sfac069 source
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured - cites [40] source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationExcess adiposity was associated with inadequate glycemic control in patients with type 1 diabetes in the T1D Exchange study cohort.
“Excess adiposity was associated with inadequate glycemic control in patients with T1D in the T1D Exchange study cohort.34”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [34] 34. Schauer IE, Snell-Bergeon JK, Bergman BC, et al. Insulin resistance, defective insulin-mediated fatty acid suppres- sion, and coronary artery calcification in subjects with and without type 1 diabetes: The CACTI study. Diabetes 2011; 60(1):306-314; doi: 10.2337/db10-0328 source
The Results section identifies the study population as the CACTI cohort, not the T1D Exchange cohort. It reports that BMI did not differ across glycemic-control (GHb) quartiles in CACTI, but that finding cannot establish whether excess adiposity was associated with inadequate glycemic control in T1D Exchange. Searches for T1D Exchange and for an adiposity–glycemic-control association found no passage addressing that cohort-specific claim. (LLM, conf=0.78)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationThe risk of pancreatitis was increased 9-fold, bowel obstruction 4-fold, and gastroparesis 3.67 times among GLP-1 users compared with bupropion-naltrexone users.
“The risk of pancreatitis was increased 9-fold, bowel obstruction 4-fold, and gastroparesis 3.67 times among GLP-1 users compared with bupropion-naltrexone users.39”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [39] 39. Kolkailah AA, Lingvay I, Dobrecky-Mery I, et al. Effects of once-weekly subcutaneous semaglutide on coronary artery disease outcomes in patients with type 2 diabetes with or at high risk for cardiovascular disease: Insights from the SUSTAIN-6 trial. Diabetes Obes Metab 2023;25(4): 1117-1120; doi: 10.1111/dom.14941 source
The Methods and Results sections compare semaglutide with placebo and report coronary outcomes in patients with type 2 diabetes. Searches for pancreatitis, bowel obstruction, gastroparesis, bupropion-naltrexone, and the stated risk multiples found no passage addressing the claimed comparison. (LLM, conf=0.76)
Experimental — accuracy not yet measured
May combine two claims.
Findingown dataChange in HbA1c did not differ by either treatment drug or by insulin delivery method.
“Change in HbA1c did not differ by either treatment drug or by insulin delivery method, though there was a trend toward larger decreases in HbA1c among insulin pump/AID users and tirzepatide-treated patients (Fig. 3B).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataTotal daily insulin dose and basal and bolus insulin dose decreased significantly in the tirzepatide-treated group at all time points.
“TDD and basal and bolus insulin dose decreased significantly in the tirzepatide-treated group at all time points (Table 2).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAmong semaglutide users, 38 (76%) reached a maximum dose of 0.5 mg weekly, and 10 patients (20%) achieved a dose of 1 mg weekly or greater.
“However, the majority of semaglutide users (n = 38, 76%) reached a maximum dose of 0.5 mg weekly, with only 10 patients (20%) achieving a dose of 1 mg weekly or greater.”
- Also stated in: § Results · plain
“the number of patients reaching 0.5 mg, 1 mg, and 2 mg weekly dose of semaglutide was 38 (76%), 9 (18%), and 1 (2%).”
Quote in the paperNot a substantial claim- Also stated in: § Results · plain
May combine two claims.
Findingown dataAmong tirzepatide users, 32% achieved a maximum dose of 5 mg weekly, 42% achieved a dose of 7.5-10 mg weekly, and 20% achieved a dose of 12.5-15 mg weekly.
“Among tirzepatide users, 32% achieved a maximum dose of 5 mg weekly, 42% achieved a dose of 7.5-10 mg weekly, and 20% achieved a dose of 12.5-15 mg weekly.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataTotal daily insulin dose and basal daily insulin dose were higher in the tirzepatide group than in the control group at baseline.
“TDD and basal daily insulin dose were higher in the tirzepatide group than the control group, and HbA1c was lower in tirzepatide users than in semaglutide users (Table 1).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBMI, weight in pounds, and weight percentage decreased significantly more in the semaglutide group than in the control group at 6, 9, and 12 months.
“BMI, weight in pounds, and weight percentage decreased significantly more in the 80 [40] 64 [32] 86 [43] 0.03 Medication dose (mg) Initial dose median highest dose achieved N/A 0.25 mg weekly 0.5 mg weekly 2.5 mg weekly 7.5 mg weekly tirzepatide group than in the control group at all time points from 3 to 12 months and significantly more in the semaglutide group than in the control group at 6, 9,”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataBMI, weight in pounds, and weight percentage decreased significantly more in the tirzepatide group than in the control group at all time points from 3 to 12 months.
“BMI, weight in pounds, and weight percentage decreased significantly more in the 80 [40] 64 [32] 86 [43] 0.03 Medication dose (mg) Initial dose median highest dose achieved N/A 0.25 mg weekly 0.5 mg weekly 2.5 mg weekly 7.5 mg weekly tirzepatide group than in the control group at all time points from 3 to 12 months and significantly more in the semaglutide group than in the control group at 6, 9,”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe decrease in BMI, weight in pounds, and weight percentage was significantly greater in tirzepatide users than in semaglutide users at all time points.
“The decrease in BMI, weight in pounds, and weight percentage was significantly greater in the tirzepatide than semaglutide users at all time points (Fig. 2).”
- Also stated in: § Discussion · plain
“The weight loss was >2-fold higher among patients treated with tirzepatide as compared with those treated with semaglutide, in line with prior published data.[27][28][29][30][31]”
Quote in the paperSubstantial claim- Also stated in: § Discussion · plain
May combine two claims.
Findingown dataBy 12 months, 93% of tirzepatide users, 77% of semaglutide users, and 14% of controls had lost 5% of their baseline body weight (P < 0.0001).
“By 12 months, 93% of tirzepatide users, 77% of semaglutide users, and 14% of controls had lost 5% of their baseline body weight (P < 0.0001), and by 12 months, 87% of tirzepatide users, 47% of semaglutide users, and none of the controls had lost 10% or more of their baseline body weight (P < 0.0001).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThere was a trend toward larger decreases in HbA1c among insulin pump/AID users and tirzepatide-treated patients.
“Change in HbA1c did not differ by either treatment drug or by insulin delivery method, though there was a trend toward larger decreases in HbA1c among insulin pump/AID users and tirzepatide-treated patients (Fig. 3B).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBy 12 months, 87% of tirzepatide users, 47% of semaglutide users, and none of the controls had lost 10% or more of their baseline body weight (P < 0.0001).
“By 12 months, 93% of tirzepatide users, 77% of semaglutide users, and 14% of controls had lost 5% of their baseline body weight (P < 0.0001), and by 12 months, 87% of tirzepatide users, 47% of semaglutide users, and none of the controls had lost 10% or more of their baseline body weight (P < 0.0001).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataBaseline characteristics did not differ between cases and controls for age, sex, diabetes duration, BMI, or HbA1c.
“Matching characteristics did not differ between cases and controls.”
- Also stated in: § Results · plain
“Baseline characteristics were similar between the cases and controls, with no differences in matching variables between cases versus controls (age [40 -11 vs. 41 -11, P = 0.79], sex [72% F vs. 71% F, P = 0.76], diabetes duration [26 -13 vs. 27 -12, P = 0.39], BMI [34.2 -5.4 vs. 34.4-5.4,kg/m 2 P = 0.86], and HbA1c [7.3 -1.1% vs. 7.3 -1.1% f53 mmol/ mol for both groupsg, P = 0.93]).”
Quote in the paperSubstantial claim- Also stated in: § Results · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe median dose of tirzepatide given was 7.5 mg weekly.
“The median dose of semaglutide given was 0.5 mg weekly, and the median dose of tirzepatide given was 7.5 mg weekly (Table 1).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationIntensive insulin treatment can lead to weight gain in some people with type 1 diabetes, which may increase cardiovascular risk factors.
“However, intensive insulin treatment can also lead to weight gain in some people, which may increase cardiovascular risk factors.3,4”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [3] 3. Purnell JQ, Hokanson JE, Marcovina SM, et al. Effect of excessive weight gain with intensive therapy of type 1 dia- betes on lipid levels and blood pressure: Results from the DCCT. Diabetes Control and Complications Trial. JAMA 1998;280(2):140-146. source
- cites [4] 4. Purnell JQ, Braffett BH, Zinman B, et al. DCCT/EDIC Research Group. Impact of excessive weight gain on cardio- vascular outcomes in type 1 diabetes: Results from the diabe- tes control and complications trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study. Dia- betes Care 2017;40(12):1756-1762; doi: 10.2337/dc16-2523 source
Classified as probably not a substantial claim.
Study design and conductown dataControls were frequency matched to cases for age, sex, diabetes duration, BMI, and HbA1c.
“50 controls frequency matched for age, sex, diabetes duration, body mass index, and glycosylated hemoglobin (HbA1c) and who did not receive any weight loss medications during the study period.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationcitationThe improvement in HbA1c seen with both medications is clinically meaningful and appears to meet or exceed even the benefit of AID versus MDI.
“The improvement in HbA1c seen with both of these medications is clinically meaningful and appears to meet or exceed even the benefit of AID versus MDI.32”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] 32. Garg SK, Snell-Bergeon J, Kaur G, et al. Challenges of GLP analog use for people with type 1 diabetes: Issues with prior approvals and tips for safer use. Diabetes Technol Ther 2024;26(6):363-366; doi: 10.1089/dia.2024.0023 source
Classified as probably not a substantial claim. May combine two claims.
Study design and conductown dataThe study assessed glucose control (HbA1c) throughout the study period and collected insulin dose information.
“The strengths of our article include real-world use of anti-OB drugs in OW and OB patients with T1D, follow-up for up to 1 year, frequency matched controls with a similar BMI followed during the same time period and with similar rates of commercial insurance, assessment of glucose control (HbA1c) throughout the study period, and insulin dose information.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataThe study lacked data from diverse populations; 85% of subjects were non-Hispanic White and all were seen at a specialty diabetes clinic.
“The weaknesses are retrospective chart review, small sample size, lack of information regarding titration schedule used and side effects experienced, off-label use of these medications in patients with T1D, and lack of data from diverse populations (*85% of subjects were non-Hispanic White, all seen at a specialty diabetes clinic).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationOverweight and obesity contribute to insulin resistance and higher insulin dose requirements.
“OW and OB also contribute to insulin resistance and higher insulin dose requirements, 35 and this combination of T1D with OB and insulin resistance has sometimes been referred to as”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [35] 35. Garg SK, Kaur G, Haider Z, et al. Efficacy of semaglutide in overweight and obese patients with type 1 diabetes. Diabetes Technol Ther 2024;26(3):184-189; doi: 10.1089/dia.2023.0490 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe study had follow-up for up to 1 year.
“The strengths of our article include real-world use of anti-OB drugs in OW and OB patients with T1D, follow-up for up to 1 year, frequency matched controls with a similar BMI followed during the same time period and with similar rates of commercial insurance, assessment of glucose control (HbA1c) throughout the study period, and insulin dose information.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAs these drugs can have significant GI side effects, doses are typically titrated gradually every month/2 months to minimize side effects.
“As these drugs can have significant GI side effects (nausea, vomiting, diarrhea, and/or constipation), doses are typically titrated gradually every month/2 months to minimize side effects.33”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [33] 33. Bailey R, Calhoun P, Garg SK. Weight gain and glycemic control in adults with type 1 diabetes in the T1D exchange registry. Diabetes Technol Ther 2024;26(3):156-160; doi: 10.1089/dia.2023.0389 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningDue to the retrospective nature of this study, it is not possible to know how much side effects contributed to the lower doses achieved by many patients.
“Due to the retrospective nature of this study, it isn't possible to know how much side effects contributed to the lower doses achieved by many patients.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductown dataThe study was a retrospective chart review.
“The weaknesses are retrospective chart review, small sample size, lack of information regarding titration schedule used and side effects experienced, off-label use of these medications in patients with T1D, and lack of data from diverse populations (*85% of subjects were non-Hispanic White, all seen at a specialty diabetes clinic).”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataThe study used frequency matched controls with similar BMI followed during the same time period and with similar rates of commercial insurance.
“The strengths of our article include real-world use of anti-OB drugs in OW and OB patients with T1D, follow-up for up to 1 year, frequency matched controls with a similar BMI followed during the same time period and with similar rates of commercial insurance, assessment of glucose control (HbA1c) throughout the study period, and insulin dose information.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe study lacked information regarding titration schedule used and side effects experienced.
“The weaknesses are retrospective chart review, small sample size, lack of information regarding titration schedule used and side effects experienced, off-label use of these medications in patients with T1D, and lack of data from diverse populations (*85% of subjects were non-Hispanic White, all seen at a specialty diabetes clinic).”
Quote in the paperNot a substantial claim
The paper relies on this without support.
People with type 1 diabetes are increasingly using these drugs off-label.
“However, people with T1D are increasingly using these drugs off-label.”
The paper relies on this without support.
None of the newer GLP receptor agonists have FDA approval for use in patients with type 1 diabetes.
“None of the newer GLP receptor agonists have FDA approval for use in patients with T1D despite the high level of OW/OB and the need for adjunctive therapies to address suboptimal glucose control on insulin.”
The paper relies on this without support.
GLP-1 receptor agonists such as semaglutide and GIP plus GLP dual agonists such as tirzepatide can improve glucose control and cause significant weight loss.
“Novel therapies including glucagon-like peptide 1 receptor agonists (GLP) such as semaglutide and glucosedependent insulinotropic polypeptide (GIP) plus GLP dual agonists such as tirzepatide can not only improve glucose control but also cause significant weight loss.”
The authors state this as an assumption.
This is the first report of the use of these two novel agents in overweight and obese patients with type 1 diabetes for up to 1 year.
“To the best of our knowledge, this is the first report of the use of these two novel agents in OW and OB patients with T1D for up to 1 year.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In overweight and obese adults with type 1 diabetes, tirzepatide was associated with a 0.68% decrease in HbA1c over 12 months.
“Both groups also showed reductions in HbA1c: a 0.54% decrease for semaglutide and a 0.68% decrease for tirzepatide, with statistical significance (P < 0.0001) [53].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [53]
The Change in HbA1c section reports a 0.68% decrease for tirzepatide users at 12 months, and the Discussion reports the cited 0.54% decrease for semaglutide users. But the citing sentence appears to apply P < 0.0001 to both groups; the paper’s Abstract gives P = 0.0001 for the semaglutide decrease and P < 0.0001 for the tirzepatide decrease. Page numbers were not provided in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn overweight and obese adults with type 1 diabetes, semaglutide was associated with a 0.54% decrease in HbA1c over 12 months.
“Both groups also showed reductions in HbA1c: a 0.54% decrease for semaglutide and a 0.68% decrease for tirzepatide, with statistical significance (P < 0.0001) [53].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [53]
In overweight and obese adults with type 1 diabetes, semaglutide users experienced an average weight loss of 9.1% (approximately 8.7 kg) over 12 months.
“Semaglutide users experienced an average Weight loss of 9.1% (approximately 8.7 kg), while tirzepatide users lost 21.4% of their body weight (approximately 49.4 lbs).”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [53]
In overweight and obese adults with type 1 diabetes, tirzepatide users lost 21.4% of their body weight (approximately 49.4 lbs) over 12 months.
“Semaglutide users experienced an average Weight loss of 9.1% (approximately 8.7 kg), while tirzepatide users lost 21.4% of their body weight (approximately 49.4 lbs).”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [53]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Control-group insurance count does not match its percentage
MinorThe table reports 29 insured controls out of 50 as 88%, but 29 out of 50 is 58%.
Reported 88 · recomputed 58
“| Commercial health insurance (% [n]) BMI (kg/m 2 ) | 88 [29] 34.4 -0.8 | 92 [46] 33.4 -0.8 | 94 [47] 35.0 -0.8 | 0.62 0.35 |”
Baseline HbA1c conversion conflicts with Table 1
MinorThe results assign 53 mmol/mol to the 7.3% baseline HbA1c in both the combined cases and controls. Table 1 instead pairs the controls' 7.3% with 56 mmol/mol.
“HbA1c [7.3 -1.1% vs. 7.3 -1.1% f53 mmol/ mol for both groupsg, P = 0.93]”
“| HbA1c (% [mmol]) | 7.3 -0.2 | 7.6 -0.2 | 7.0 -0.2* | 0.02 | | | [56 mmol/mol] | [60 mmol/mol] | [53 mmol/mol] | |”
Reported racial composition conflicts with group percentages
MinorThe discussion says approximately 85% of subjects were non-Hispanic White, whereas Table 1 reports 90%, 90%, and 86% across three equally sized groups. Their combined percentage must be between 86% and 90%, not approximately 85%.
“(*85% of subjects were non-Hispanic White, all seen at a specialty diabetes clinic)”
“| Non-Hispanic White (% [n]) | 90 [45] | 90 [45] | 86 [43] | 0.62 |”
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“Newer therapies for diabetes and technologies for continuous glucose monitoring have improved the quality of life by offering greater flexibility and reducing the burden of constant monitoring and adjustments, especially in T1DM 250 .”
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“16 17 – 19 Tirzepatide, semaglutide and liraglutide also led to modest improvements in HbA1c.”
InfluentialDutta, D., Kamrul-Hasan, A. B. M., Jindal, R., Mohindra, R., Nagendra, L., & Bhattacharya, S. (2025) · Medicine · doi:10.1097/md.0000000000046446 · Cited by 9 · see citing works
Munawar, N., Mahato, A., Rawat, A., Gill, F. S., Kumar, D., Katwal, S., Wei, C. R., & Ali, N. (2025) · Cureus · doi:10.7759/cureus.86080 · Cited by 8 · see citing works
Mertens, J., Winter, H. T. D., Dirinck, E. L., Francque, S., & Block, C. E. M. D. (2025) · Diabetes Technology & Therapeutics · doi:10.1177/15209156251362497 · Cited by 7 · see citing works
“13 16 A recent consensus report on the use of GLP-1RAs in T1D concluded that, although off-label, their use may offer bene fi cial effects, including reductions in glycated hemoglobin A1c (HbA1c), body weight, and total daily insulin requirements.”
Registration and Real-Life Studies on Automated Insulin Delivery Systems
Aktürk, H. K., Brown, S. A., Beck, R. W., Sherr, J. L., Bergenstal, R. M., Kovatchev, B. P., Vigersky, R. A., Breton, M. D., Hovorka, R., Klonoff, D. C., et al. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251334993 · Cited by 6 · see citing works
Self-citationRegistration and Real-Life Studies on Automated Insulin Delivery Systems
Aktürk, H. K., Brown, S. A., Beck, R. W., Sherr, J. L., Bergenstal, R. M., Kovatchev, B. P., Vigersky, R. A., Breton, M. D., Hovorka, R., Klonoff, D. C., et al. (2025) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2025.0130 · Cited by 6 · see citing works
“A recent study reported an exponential increase in the off-label use of SGLT 2 inhibitors and GLP-1RA analogs in patients with T1D, especially those with cardiovascular disease and DKD. 64 70 A small study even reported using GLP-1RA in new-onset antibody-positive patients with T1D.”
Self-citationNoninsulin Therapies in Management of Type 1 Diabetes
Saeed, Z. I., Ambalavanan, J., Rayan, M. N., Patadia, P., & Shah, V. N. (2025) · Endocrine Practice · doi:10.1016/j.eprac.2025.06.027 · Cited by 5 · see citing works
Garg, S., Kim, S., Ford, A. M., Loesch, J., Valencia, S. O., Zhou, K., & Lembo, A. J. (2025) · Diabetes Technology & Therapeutics · doi:10.1177/15209156251403555 · Cited by 4 · see citing works
“15 Despite promising fi ndings from multiple retrospective and small prospective studies showing improvement in short-and medium-term outcomes of safety and metabolic parameters, real-world evidence on the long-term outcomes, including emergency department (ED) visits, hospitalizations, and…”
Self-citationZufry, H., & Hariyanto, T. I. (2026) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2026.02.002 · Cited by 5 · see citing works
Tirzepatide as adjunct to insulin for the treatment of type 1 diabetes
Patoulias, D., Teperikidis, E., Popovic, D. S., Karakasis, P., & Koufakis, T. (2025) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2025.106624 · Cited by 3 · see citing works
Garg, S. K., Aktürk, H. K., Garg, S., Beck, R. W., Bellini, N. J., Bjornstad, P., Carlson, A. L., Carroll, J., Close, K., Block, C., et al. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156261449879 · Cited by 6 · see citing works
Self-citationAktürk, H. K., Karakus, K. E., Cengiz, D., Mason, E., Beck, E., Kaur, G., & Garg, S. K. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156251398060 · Cited by 3 · see citing works
Self-citationRevolutionizing Diabetes Care: From Tech to Therapeutics
Aktürk, H. K., WATERMAN, L. A., & Cobry, E. C. (2025) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s580423 · Cited by 2 · see citing works
Self-citationThe Future of Dual Glucose–Ketone Monitoring in Youth with Diabetes
Sherr, J. L., & Cobry, E. C. (2025) · Diabetes Technology & Therapeutics · doi:10.1177/15209156251370944 · Cited by 4 · see citing works
“57,58 DGK has the potential to provide additional monitoring support to ensure that the decrease in glucose and insulin dosing will not result in ketosis and increase the risk for DKA.”
Lisco, G., Tullio, A. D., Disoteo, O., Armigliato, M., Guastamacchia, E., Marucci, S., Pergola, G. D., Papini, E., Chianelli, M., Frasoldati, A., et al. (2025) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.70073 · Cited by 2 · see citing works
Angiogenesis and inflammation in the retinopathy risk of insulin and semaglutide – a review
Lu, M. (2026) · International Journal of Retina and Vitreous · doi:10.1186/s40942-026-00811-8 · Cited by 1 · see citing works
“Both semaglutide and tirzepatide have been used as add-on therapies to insulin in patients with T1D and obesity, producing additional HbA1c reductions of up to 0.54% and 0.68%, respectively [82, 83].”
InfluentialAktürk, H. K., Mason, E., Cengiz, D., Karakus, K. E., & Garg, S. K. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156261423903 · Cited by 1 · see citing works
“4 Our study included 82 subjects who had used both tirzepatide and semaglutide at different times, enabling within-person comparisons.”
Self-citationRole of Continuous Dual Glucose–Ketone Monitoring in Diabetes Care
Garg, S. K., & Parkin, C. G. (2025) · Diabetes Technology & Therapeutics · doi:10.1177/15209156251369529 · Cited by 1 · see citing works
Self-citationWang, W. T., & Loh, W. J. (2025) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000940 · Cited by 2 · see citing works
Kitsios, K., & Trakatelli, C. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156261486127
Type 1 diabetes in the era of obesity: Pathophysiology and therapeutic implications
Bloomgarden, Z. T. (2026) · Journal of Diabetes Investigation · doi:10.1111/jdi.70427
“In a specialty-clinic cohort, semaglutide and tirzepatide were associated with weight loss and improved HbA1c in overweight or obese adults with T1D 32 .”
Almoallem, B., & Thalange, N. K. S. (2026) · Cureus · doi:10.7759/cureus.114782
Polsky, S., Beck, E., Shah, A., Cengiz, D., & Garg, S. K. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156261468108
Self-citationBerry, S. A., Goodman, I. R., McNally, E. H., Elliott, J., & Iqbal, A. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.71080 · Cited by 1 · see citing works
Weekly Glucagon-Like Peptide-1 Receptor Agonists in Type 1 Diabetes
Buros‐Stein, A., PAULEY, M. E., & Snell‐Bergeon, J. K. (2026) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2026.04.003
Self-citationLucove, J. C., CORNELIUS, E. M., Nguyen, H. T., Shah, V. N., Sherr, J. L., Kudva, Y. C., Carlson, A. L., & Wolf, W. A. (2026) · Diabetes Technology & Therapeutics · doi:10.1177/15209156261444998
Mertens, J., Spinhoven, M. J., Braspenning, R., Vanhevel, F., Dirinck, E. L., Block, C. E. M. D., & Francque, S. (2026) · JHEP Reports · doi:10.1016/j.jhepr.2026.101887
“…prompt more thorough measures in several treatment areas: (1) in weight management, where incretin mimetics are reportedly effective in T1D; 22,43–45 (2) intensification of physical activity can help reduce insulin resistance; and (3) the traditional targets for reduction of cardiovascular risk…”
Acucella, G. A., & Caponio, D. (2026) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70225 · Cited by 1 · see citing works
Tirzepatide Use in Overweight and Obese Middle Eastern Patients With Type 1 Diabetes Mellitus
Chaaya, J. A., Aleid, B., Abdallah, O., Alomari, N. A., Jaafar, B., & Chaaya, J. A. (2026) · AACE Endocrinology and Diabetes · doi:10.1016/j.aed.2026.04.003
Soliman, A., Hamour, B., Hammad, A., Yousry, O., Samy, S., Hussein, A., Elmorsy, S. A., Nabeh, O. A., Elkholy, E. M., & Salam, R. (2026) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-026-01880-0 · Cited by 1 · see citing works
“After applying inclusion and exclusion criteria, 6 studies were included in this systematic review and meta-analysis, namely those by Akturk et al. [2 ], Gebre et al. [ 13 ], Garg et al. (2025), Gutierrez et al. (2024), Karakus et al. [19 ], and Snell-Bergeon et al. [ 28 ].”
InfluentialCastellana, E., Budau, P. M., & Chiappetta, M. R. (2026) · Journal of Pharmacy Technology · doi:10.1177/87551225261422610
“22 Although pharmacotherapy can achieve significant weight loss, long-term safety data in T1D populations are limited, representing a key knowledge gap that warrants further investigation.”
InfluentialNeue Wege in der Behandlung des Typ-1-Diabetes?
Moser, J. (2025) · Info Diabetologie · doi:10.1007/s15034-025-5198-9
Ranting in 2025: It’s Not the Same Rant
Hirsch, I. B. (2025) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2025.0005
- Authors
- Snell-Bergeon, J. K., Kaur, G., Renner, D., Akturk, H. K., Beatson, C., & Garg, S. K.
- Affiliations
- Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado, USA.
- University of Colorado Denver (US)
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2025-01
- Volume
- 27
- Issue
- 1
- Pages
- 1-9
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- OpenAlex
- W4405990781
- Cited by
- 40
- References
- 40
- Citations by year
- 2026: 19 · 2025: 21
- FWCI
- 27.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Technology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- semaglutide, tirzepatide, type 1 diabetes, obesity, overweight, weight loss, glycemic control, HbA1c, off-label drug use, GLP-1 receptor agonists, GIP/GLP-1 receptor agonist, real-world effectiveness
- MeSH terms
- Tirzepatide, Semaglutide, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Glucagon-Like Peptides, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Middle Aged, Obesity, Retrospective Studies, Weight Loss, Body Mass Index, Treatment Outcome, Overweight, Glucagon-Like Peptide 1
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