People With Type 1 Diabetes Want GLP-1 Drugs as Add-On Therapy for Unmet Treatment Needs | Research

The takeaway

A survey of 133 type 1 diabetes patients found that 94% would use adjunctive therapies like GLP-1 receptor agonists, with weight management, glycemic control, and treatment fatigue as top unmet needs.

94% would use adjunctive therapies
Adults with type 1 diabetes reporting strong willingness to add GLP-1 receptor agonists to their insulin regimen, with 94% preferring liraglutide's risk-benefit profile over placebo

What the researchers found

In a survey of 133 adults with type 1 diabetes, 28% reported unmet treatment needs, primarily in glycemic control, management-related fatigue, and weight management. An overwhelming 94% indicated willingness to use adjunctive therapies alongside insulin. When presented with masked drug profiles, 94% preferred liraglutide's risk-benefit profile (1.8 mg, then 0.6 mg) over placebo. Preferred administration routes were daily tablets (66%) and weekly injections (32%). Semi-structured interviews with 20 participants confirmed and extended these findings.

Why it matters

GLP-1 receptor agonists are not currently approved for type 1 diabetes, yet this survey shows that T1D patients have significant unmet needs that align closely with GLP-1RA benefits — particularly weight management, reduced glycemic variability, and potentially reduced insulin doses. Understanding patient willingness and preferences is essential for designing clinical trials and guiding regulatory decisions about expanding GLP-1RA indications to T1D.

The numbers in context

n=133 surveyed · 28% unmet needs · 94% willing to use adjunctive therapy · 94% preferred liraglutide profile · 66% preferred daily tablets · 32% preferred weekly injections · n=20 interviewed

How the study worked

Mixed-methods study: (1) Quantitative online survey of 133 adults with T1D assessing demographics, management data, priorities, satisfaction, and willingness to use adjunctive therapies; (2) Risk-benefit analysis using three masked drug profiles (liraglutide 1.8 mg, 0.6 mg, and placebo); (3) Semi-structured qualitative interviews with 20 respondents for deeper insights.

Who was studied

133 adults with type 1 diabetes completing an online survey, with 20 participating in semi-structured interviews

What this study cannot tell us

Self-reported data may be subject to selection bias — individuals motivated to seek new treatments may be overrepresented. The sample size of 133 is modest. The masked drug profiles assessed willingness based on described benefits and risks, not actual treatment experience. GLP-1RAs are not approved for T1D, and the survey cannot assess clinical efficacy or safety in this population.

How to read the evidence

This is a cross-sectional survey study capturing patient perspectives and preferences, not clinical efficacy data. While the sample size (133) is adequate for a survey study and the mixed-methods approach adds depth, this does not demonstrate that GLP-1RAs are safe or effective in T1D.

When this study was published

Published in 2024, this study captures patient attitudes during a period of rapidly expanding GLP-1RA use for type 2 diabetes and obesity. Growing public awareness of these drugs likely influences T1D patient interest.

The bigger picture

GLP-1 receptor agonists have transformed type 2 diabetes and obesity treatment, but their role in type 1 diabetes remains undefined. Small clinical trials have shown potential benefits (reduced insulin requirements, improved weight, less glycemic variability), but safety concerns — particularly diabetic ketoacidosis risk — have slowed regulatory progress. This patient perspective study adds an important voice to the conversation: T1D patients themselves want access to these drugs and are willing to accept their risk-benefit profile.

Questions still open

Would a large-scale randomized trial of GLP-1RAs in T1D demonstrate a favorable safety profile, particularly regarding DKA risk?
Could oral GLP-1 formulations (like oral semaglutide) address the strong patient preference for daily tablets over injections?
Would GLP-1RAs reduce management-related fatigue in T1D by simplifying glycemic control and reducing insulin dose burden?

Common questions

Why aren't GLP-1 drugs approved for type 1 diabetes?

GLP-1 receptor agonists were developed for type 2 diabetes, where they improve insulin secretion from the pancreas. In type 1 diabetes, the pancreas produces little or no insulin, so this primary mechanism doesn't apply. However, GLP-1 drugs have other effects — reducing appetite, slowing stomach emptying, and suppressing glucagon — that could benefit T1D patients. Safety concerns, particularly the risk of diabetic ketoacidosis (DKA) if insulin doses are reduced too much, have slowed approval for this population.

What were the main unmet needs reported by type 1 diabetes patients?

The top three unmet needs were: (1) glycemic control — difficulty keeping blood sugar in range despite insulin; (2) management-related fatigue — the exhausting daily burden of constant monitoring, insulin dosing, and decision-making; and (3) weight management — insulin therapy can cause weight gain that's difficult to manage. GLP-1 drugs could potentially address all three of these concerns.

Read the original research

Can Unmet Needs Be Addressed by Adjunctive Therapies? Findings from a Patient Perspectives Survey in Adults with Type 1 Diabetes.

Journal of patient experience, 11, 23743735241257811

View on PubMed ↗Publisher’s paper ↗

Citation

Lamaro, Bella D; Greenfield, Jerry R; Snaith, Jennifer R. (2024). Can Unmet Needs Be Addressed by Adjunctive Therapies? Findings from a Patient Perspectives Survey in Adults with Type 1 Diabetes.. Journal of patient experience, 11, 23743735241257811. https://doi.org/10.1177/23743735241257811