Key takeaways:
- Semaglutide improved time in glycemic vary in sufferers with sort 1 diabetes and weight problems utilizing an automatic insulin supply system.
- The GLP-1 additionally decreased physique weight and maintained low hypoglycemia charges.
CHICAGO — Semaglutide improved time spent in glycemic vary, time beneath fee and decreased physique weight with low charges of hypoglycemia in contrast with placebo in sufferers with sort 1 diabetes and weight problems utilizing an automatic insulin supply system.
Viral N. Shah, MD, professor of drugs within the division of endocrinology and metabolism and director of diabetes scientific analysis at Indiana College Middle for Diabetes and Metabolic Ailments, introduced outcomes of the ADJUST-T1D trial on the American Diabetes Affiliation Scientific Periods that have been concurrently revealed in NEJM Proof.
Adults with sort 1 diabetes had a higher discount in HbA1c and enchancment in time in vary with semaglutide than placebo. Picture: Adobe Inventory
ADJUST-T1D enrolled 72 adults with sort 1 diabetes for a minimum of 1 yr who have been utilizing an automatic insulin supply system (Medtronic 770G; Tandem Management IQ; Omnipod 5 [Insulet Corp.]) for a minimum of 3 months. Baseline HbA1c was 7% to 10% and BMI was 30 kg/m2 or greater. Individuals have been randomly assigned to additionally obtain semaglutide (Ozempic, Novo Nordisk) or placebo.
Viral N. Shah
The trial featured a dose titration interval of 0.25 mg semaglutide or placebo for 4 weeks, adopted by 0.5 mg, after which members continued at 1 mg for the remainder of the scientific trial interval, which ended at 26 weeks. The trial was absolutely concluded after a 2-week security interval, throughout which members transitioned again to their pretrial automated insulin supply system settings.
The typical age of members was roughly 40 years and greater than half have been ladies. The typical diabetes period amongst trial members was round 22 years.
The first composite endpoint comprised a minimum of 70% of steady glucose monitoring-based time between 70 mg/dL and 180 mg/dL of 70%, lower than 4% of time spent beneath 70 mg/dL and 5% or higher discount in physique weight.
At 26 weeks, 36% of members assigned to semaglutide met all three elements of the first composite final result in contrast with not one of the placebo group (P < .001), in accordance with the outcomes.
Individuals within the semaglutide group additionally had a higher imply change from baseline in HbA1c in contrast with placebo (adjusted group distinction, –0.3%; 95% CI, –0.6 to –0.05).
Individuals assigned semaglutide spent practically 9% extra time in vary vs. placebo (8.8%; 95% CI, 3.9-13.7), in accordance with the presentation.
At baseline, the imply physique weight of these assigned to semaglutide was 99 kg vs. 104 kg within the placebo group. These assigned semaglutide skilled higher common weight reduction vs. placebo (adjusted group distinction, –8.8 kg; 95% CI, –10.6 to –7).
“We wished to ensure that we’re taking good care of each glycemia in addition to weight in these people,” Shah mentioned throughout the press convention.
In an exploratory evaluation, Shah and colleagues reported a 30% discount in insulin dose by week 26 amongst these assigned semaglutide vs. placebo, which remained vital after adjusting for weight reduction throughout the trial.
Total, 53% of members assigned semaglutide skilled gastrointestinal occasions vs. 25% of the placebo group. One critical hostile occasion occurred within the semaglutide group throughout the first injection; nonetheless, the affected person continued within the trial.
“Semaglutide, in folks with sort 1 diabetes with a BMI of greater than 30 kg/m2, was discovered to be very efficient in enhancing time in vary, lowering physique weight and it seems to be secure and sturdy. Discontinuation was solely in two members out of 36 … which is similar to different high-dose semaglutide and weight problems trials,” Shah mentioned throughout the press convention.
Reference:
Sources/Disclosures
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Shah VN, et al. Symposium – ADJUnct semaglutide therapy in sort 1 diabetes (ADJUST-T1D) trial outcomes. Offered at: American Diabetes Affiliation’s Scientific Periods; June 20-23, 2025; Chicago.
Disclosures:
The ADJUST-T1D trial was funded by Breakthrough T1D. The examine drug was supplied by Novo Nordisk beneath an NNI investigator-initiated research program. Shah studies consulting for Dexcom, Genomelink, Insulet Corp., Lilly Diabetes and Lumosfit; serving on advisory panels for Ascensia Diabetes Care, Embecta, Novo Nordisk, Sanofi, Tandem Diabetes Care; and receiving analysis assist from Allow Bioscience.
