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Glucagon-like peptide-1 agonists' effects on glycemic control, weight loss, and beta cells function in type 1

Hyder O Mirghani1, Laila Albishi2, Sawsan Mohmed Alblewi2

  • 1Internal Medicine Department, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.

Frontiers in Endocrinology
|March 27, 2026
PubMed
Abstract

Insights

Glucagon-like peptide-1 (GLP-1) agonists significantly reduced weight, HbA1c, and hyperglycemia in type 1 diabetes mellitus (T1DM) patients. However, they increased adverse events without affecting hypoglycemia or C-peptide levels.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Insulin therapy for type 1 diabetes mellitus (T1DM) often results in suboptimal glycemic control, weight gain, and hypoglycemia.
  • Adjuvant therapies are crucial to mitigate these adverse effects and improve T1DM management.
  • Existing meta-analyses on glucagon-like peptide-1 (GLP-1) agonists in T1DM are limited, particularly concerning weight and HbA1c outcomes.

Purpose of the Study:

  • To assess the efficacy of GLP-1 agonists as an adjuvant therapy in T1DM patients.
  • To evaluate the impact of GLP-1 agonists on HbA1c, weight, and C-peptide levels in T1DM.
  • To analyze the effects across T1DM patients with varying body weights (obesity/overweight and normal weight).

Main Methods:

  • A systematic literature search was conducted across PubMed, Web of Science, Cochrane Library, and Google Scholar up to October 30, 2025.
  • Keywords included T1DM, GLP-1 agonists, weight, HbA1c, hyperglycemia, adverse effects, hypoglycemia, and C-peptide.
  • A meta-analysis included data from 18 eligible studies identified from an initial pool of 904 studies.

Main Results:

  • GLP-1 agonists demonstrated significant reductions in weight (MD=-4.28), HbA1c (MD=-0.4), and time spent in hyperglycemia (MD=-1.98) compared to controls.
  • No significant differences were observed in the time spent in hypoglycemia (MD = 0.08) or maximum stimulated C-peptide levels.
  • The incidence of total adverse events was higher in the GLP-1 agonist group.

Conclusions:

  • GLP-1 agonists offer a promising adjuvant therapy for T1DM, effectively reducing weight, HbA1c, and hyperglycemia.
  • These benefits are associated with an increased risk of adverse events, while hypoglycemia and C-peptide levels remain unaffected.
  • Further rigorous trials are recommended to explore GLP-1 agonists in newly diagnosed and normal-weight T1DM populations.
Keywords:
GLP-1 agonistsHbA1cT1DMweightβ cells

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