Incretin Hormones May Address Cardiovascular Risk in Type 1 Diabetes | Research

The takeaway

Type 1 diabetes involves dysfunctional GIP, GLP-1, and glucagon signaling that contributes to cardiovascular risk, and emerging incretin-based therapies may directly target these metabolic deficits.

Underserved population
T1D patients have significantly increased cardiovascular risk but no approved incretin-based therapies despite clear metabolic rationale

What the researchers found

T1D involves dysfunctional GIP, GLP-1, and glucagon signaling that contributes to dysglycemia and cardiovascular risk, with semaglutide and tirzepatide emerging as potential therapeutic options targeting these specific metabolic deficits.

Why it matters

T1D patients have no approved incretin-based therapies despite clear metabolic rationale. Demonstrating cardiovascular benefits could expand GLP-1 drug indications to T1D.

How the study worked

Narrative review of incretin hormone physiology in T1D, focusing on GIP, GLP-1, and glucagon dysfunction and emerging therapeutic opportunities with incretin-based drugs.

What this study cannot tell us

Mostly conceptual/review without new data. Clinical trials of GLP-1 drugs in T1D for cardiovascular outcomes are limited. Dosing and safety in T1D need separate validation.

How to read the evidence

Narrative review presenting mechanistic rationale. Limited clinical data for GLP-1 drugs in T1D cardiovascular outcomes.

When this study was published

Published in 2025.

The bigger picture

Extending incretin-based therapies from T2D to T1D could address cardiovascular risk in a population that has been largely excluded from the GLP-1 revolution.

Questions still open

Would cardiovascular outcome trials of semaglutide in T1D be feasible and ethical?
How does incretin dysfunction in T1D differ from T2D?
Could tirzepatide's dual mechanism offer advantages over GLP-1 monotherapy in T1D?

Common questions

Can people with type 1 diabetes take GLP-1 drugs?

GLP-1 drugs are not currently approved for T1D, but this review argues they could help by correcting incretin hormone dysfunction that contributes to blood sugar swings and cardiovascular risk. Clinical trials are needed.

Why do T1D patients have high heart risk?

Beyond blood sugar management challenges, T1D involves disrupted incretin hormones (GLP-1, GIP) and glucagon signaling that affect blood vessels and metabolism. Incretin-based drugs could potentially address these specific deficits.

Read the original research

Targeting cardiometabolic risk in type 1 diabetes through incretin physiology.

Trends in endocrinology and metabolism: TEM, 37(2), 135-150

View on PubMed ↗Publisher’s paper ↗

Citation

Frampton, Ruth; Hocking, Samantha; Snaith, Jennifer R; Greenfield, Jerry R. (2026). Targeting cardiometabolic risk in type 1 diabetes through incretin physiology.. Trends in endocrinology and metabolism: TEM, 37(2), 135-150. https://doi.org/10.1016/j.tem.2025.06.004