GLP-1-based therapies show cardiorenal benefits and reassuring safety in type 1 diabetes

Individuals with type 1 diabetes (T1D) face elevated risks for cardiovascular (CV) and renal complications, yet specific therapeutic strategies to reduce these cardiorenal risks in this population are scarce. While GLP-1 receptor agonists (GLP-1RAs) are well-established for type 2 diabetes and obesity, their role in T1D has traditionally focused on glycemic control. This gap highlights the need to explore whether GLP-1-based therapies offer broader protective effects beyond glucose regulation in T1D, particularly concerning critical cardiorenal outcomes.

This study conducted a comprehensive review of published literature to examine the CV, clinical, and renal effects of GLP-1-based therapies in adults with type 1 diabetes. Researchers also evaluated safety outcomes, including risks of diabetic ketoacidosis and severe hypoglycemia, and identified future research priorities. The review specifically identified and analyzed three observational real-world studies that investigated GLP-1-based therapies in T1D populations, synthesizing their findings on major clinical outcomes and safety profiles.

Analysis of three observational real-world studies revealed clinically meaningful benefits of GLP-1-based therapies in adults with type 1 diabetes.

These therapies demonstrated significant reductions in all-cause mortality, hospitalisation, heart failure, and composite CV outcomes. Renal benefits were also observed, including lower risks of early estimated glomerular filtration rate (eGFR) decline and end-stage kidney disease (ESKD). Crucially, the review found no consistent increase in diabetic ketoacidosis (DKA) or severe hypoglycemia, supporting a generally reassuring safety profile. These findings challenge the traditional view that GLP-1 receptor agonists are primarily for glycemic control in T1D, suggesting a broader role in cardiorenal risk reduction.