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

Pasqua, Melissa-Rosina et al.·Nature medicine·2025·Moderate EvidenceRandomized Controlled Trial
RPEP-12971Randomized Controlled TrialModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=28
Participants
Adults with type 1 diabetes using automated insulin delivery

What This Study Found

Semaglutide added to automated insulin delivery in type 1 diabetes increased time in glucose target range by 4.8 percentage points without increasing hypoglycemia. Two cases of euglycemic ketosis occurred.

Key Numbers

28 randomized, 24 completed. Time in range (3.9-10.0 mmol/L) increased 4.8 percentage points (SD 7.6, P = 0.006). No increase in time below 3.9 (P = 0.19) or 3.0 mmol/L (P = 0.65). No DKA or severe hypoglycemia. 2 euglycemic ketosis episodes. Max dose 1 mg.

How They Did This

Randomized, double-blind, crossover trial. Semaglutide titrated up to 1 mg over 11 weeks, then 4 weeks on automated insulin delivery. Primary endpoint: time in target glucose range during last 4 weeks.

Why This Research Matters

Type 1 diabetes management remains challenging even with insulin pumps. This is the first blinded trial showing semaglutide can improve glucose control in T1D when paired with automated insulin delivery.

What This Study Doesn't Tell Us

Very small (28 randomized, 24 completed). Short treatment period (15 weeks total). Crossover design may have carryover effects. Euglycemic ketosis is a safety concern needing longer-term data.

Trust & Context

Original Title:
Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial.
Published In:
Nature medicine, 31(4), 1239-1245 (2025)
Database ID:
RPEP-12971

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

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Cite This Study

RPEP-12971·https://rethinkpeptides.com/research/RPEP-12971

APA

Pasqua, Melissa-Rosina; Tsoukas, Michael A; Kobayati, Alessandra; Aboznadah, Wedyan; Jafar, Adnan; Haidar, Ahmad. (2025). Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial.. Nature medicine, 31(4), 1239-1245. https://doi.org/10.1038/s41591-024-03463-z

MLA

Pasqua, Melissa-Rosina, et al. "Subcutaneous weekly semaglutide with automated insulin delivery in type 1 diabetes: a double-blind, randomized, crossover trial.." Nature medicine, 2025. https://doi.org/10.1038/s41591-024-03463-z

RethinkPeptides

RethinkPeptides Research Database. "Subcutaneous weekly semaglutide with automated insulin deliv..." RPEP-12971. Retrieved from https://rethinkpeptides.com/research/pasqua-2025-subcutaneous-weekly-semaglutide-with

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Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.