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Addressing unmet needs for chronic kidney disease treatment in type 1 diabetes: A review

Katherine R Tuttle1,2, Linong Ji3, Chantal Mathieu4

  • 1Providence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, DC, USA.

Diabetes, Obesity & Metabolism
|October 7, 2025
PubMed

Insights

Chronic kidney disease (CKD) affects many with type 1 diabetes (T1D). Research is needed to see if T2D CKD treatments are safe and effective for T1D patients.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiology

Background:

  • Chronic kidney disease (CKD) is a significant complication in nearly one-third of individuals with type 1 diabetes (T1D).
  • While advancements in CKD management have benefited type 2 diabetes (T2D) patients, those with T1D have been largely excluded from therapeutic development programs.
  • Risk factors for CKD in T1D, including hyperglycemia, hypertension, and obesity, share mechanistic links with T2D.

Purpose of the Study:

  • To highlight the unmet need for improved CKD treatments in people with T1D.
  • To explore the potential of therapeutic classes proven effective in T2D for T1D CKD treatment.
  • To emphasize the need for coordinated, cross-specialty care for CKD in T1D.

Main Methods:

  • Review of recent therapeutic advancements for CKD in T2D, including SGLT2 inhibitors, nonsteroidal MRA, and GLP-1 RAs.
  • Examination of shared risk factors and mechanistic links between CKD in T1D and T2D.
  • Discussion of the necessity for focused clinical studies in T1D.

Main Results:

  • Proven therapies for T2D CKD include SGLT2 inhibitors, nonsteroidal MRA, and GLP-1 RAs.
  • Shared risk factors suggest a rationale for investigating these therapies in T1D.
  • Coordinated, multidisciplinary care is crucial for effective CKD management.

Conclusions:

  • There is a major unmet need for effective CKD treatments in people with T1D.
  • Future studies are essential to determine the safety and efficacy of T2D CKD therapies in the T1D population.
  • Integrated care approaches are vital to improve kidney, cardiovascular, and survival outcomes in T1D.

Keywords:
GLP‐1 analoguecardiovascular diseasediabetic nephropathytype 1 diabetes, SGLT2 inhibitor

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