Can a Type 2 Drug Improve Outcomes for Type 1 Diabetes Patients? Study Finds Out
A new clinical trial led by an Indiana University School of Medicine researcher has revealed that semaglutide, a medication primarily approved for Type 2 diabetes, may also benefit adults with Type 1 diabetes. The findings, published in NEJM Evidence, mark the first randomized clinical trial of its kind and suggest that the drug improves blood sugar control and supports weight loss in patients using automated insulin delivery systems who have a body mass index (BMI) of 30 or higher.
Semaglutide belongs to a class of medications known as GLP-1 receptor agonists. While it was originally developed for managing Type 2 diabetes, it has gained widespread attention as a weight-loss therapy. The new study set out to explore its potential as an adjunct to insulin therapy for individuals with Type 1 diabetes—a use not currently approved by the U.S. Food and Drug Administration.
In the 26-week, double-blind, placebo-controlled trial, 72 adult participants were divided evenly between a semaglutide group and a placebo group. The researchers found that 36% of patients receiving semaglutide achieved three significant clinical goals: more than 70% of time spent within the target glucose range (70–180 mg/dL), less than 4% of time spent in hypoglycemia (below 70 mg/dL), and at least a 5% reduction in body weight.
"We found that semaglutide was effective in improving time spent in the target blood sugar range and reduction in body weight compared to placebo group," said Dr. Viral Shah, the study’s lead author and a professor of medicine at IU School of Medicine.
Notably, none of the patients in the placebo group met all three outcomes. Participants on semaglutide lost an average of 20 pounds without serious complications. Two episodes of severe hypoglycemia were reported in both groups, and no cases of diabetic ketoacidosis occurred.
Dr. Shah emphasized the broader implications of the findings: "We hope that our trial will encourage the industry to conduct a regulatory approval trial so that this drug could be available as an adjunct to insulin therapy to optimize Type 1 diabetes management."
Reference: Semaglutide in Adults with Type 1 Diabetes and Obesity. Shah Viral N. et al., doi: 10.1056/EVIDoa2500173, NEJM Evidence, Massachusetts Medical Society, 2025/06/24
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