This record provides bibliographic details and links to the original research. An editorial study breakdown is not available.
What the researchers found
In adults with type 1 diabetes and obesity using automated insulin delivery, semaglutide 1 mg weekly achieved the composite endpoint (>70% time in range, <4% time below range, and ≥5% weight loss) in 36% vs 0% on placebo. HbA1c improved 0.3 points and weight decreased 8.8 kg more than placebo.
Why it matters
This is the first rigorous RCT showing semaglutide significantly improves both glucose control and weight in type 1 diabetes. It could change treatment paradigms for the growing number of T1D patients with obesity.
The numbers in context
72 adults randomized 1:1. BMI ≥30. 26 weeks. Composite endpoint met: 36% semaglutide vs 0% placebo (difference 36 pp, 95% CI 20.6-52.2, p<0.001). HbA1c difference: -0.3 pp. Time in range difference: +8.8 pp. Weight difference: -8.8 kg (95% CI -10.6 to -7.0). 2 severe hypoglycemia events per group. Zero DKA events.
How the study worked
26-week double-blind RCT (ADJUST-T1D). 72 adults with T1D, BMI ≥30, using automated insulin delivery. Semaglutide up to 1 mg weekly vs placebo. Primary composite: CGM time in range >70% + time below range <4% + ≥5% weight loss. NCT05537233.
Who was studied
Adults with type 1 diabetes and obesity (BMI ≥30) using automated insulin delivery
What this study cannot tell us
Small trial (72 patients). 26-week duration. Only BMI ≥30 included. All used AID systems, limiting generalizability. Semaglutide not yet approved for T1D. Longer-term safety data needed.
Read the original research
Semaglutide in Adults with Type 1 Diabetes and Obesity.
NEJM evidence, 4(8), EVIDoa2500173
Citation
Shah, Viral N; Akturk, Halis K; Kruger, Davida; Ahmann, Andrew; Bhargava, Anuj; Bakoyannis, Giorgos; Pyle, Laura; Snell-Bergeon, Janet K. (2025). Semaglutide in Adults with Type 1 Diabetes and Obesity.. NEJM evidence, 4(8), EVIDoa2500173. https://doi.org/10.1056/EVIDoa2500173