Semaglutide in Adults with Type 1 Diabetes and Obesity.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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.
What This Study Doesn't 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.
Trust & Context
- Original Title:
- Semaglutide in Adults with Type 1 Diabetes and Obesity.
- Published In:
- NEJM evidence, 4(8), EVIDoa2500173 (2025)
- Authors:
- Shah, Viral N, Akturk, Halis K(2), Kruger, Davida, Ahmann, Andrew, Bhargava, Anuj, Bakoyannis, Giorgos, Pyle, Laura, Snell-Bergeon, Janet K
- Database ID:
- RPEP-13531
Evidence Hierarchy
Read More on RethinkPeptides
Cite This Study
https://rethinkpeptides.com/research/RPEP-13531APA
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
MLA
Shah, Viral N, et al. "Semaglutide in Adults with Type 1 Diabetes and Obesity.." NEJM evidence, 2025. https://doi.org/10.1056/EVIDoa2500173
RethinkPeptides
RethinkPeptides Research Database. "Semaglutide in Adults with Type 1 Diabetes and Obesity." RPEP-13531. Retrieved from https://rethinkpeptides.com/research/shah-2025-semaglutide-in-adults-with
Access the Original Study
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.