ESPE Yearbook of Paediatric Endocrinology

In Brief: This research letter describes a recent case series of 10 patients aged 21–39 years who started taking Semaglutide within 3 months of their diagnosis of antibody-positive type 1 diabetes (T1D), in addition to standard basal and prandial insulin. All 10 patients stopped prandial insulin within 3 months of Semaglutide, and 7 patients also stopped basal insulin by 6 months. Mean HbA1c fell from 11.7% at diagnosis to 5.9% at 6 months and 5.7% at 12 months. Mean fasting C-peptide level increased in all patients from 0.65 to 1.05 ng/ml.

Although this is an uncontrolled case series, the reductions (and stopping) in insulin therapy are striking and the authors report that the reductions in HbA1c are greater than those in the placebo control arms of trials in similar patients. Data are restricted to the first 12 months after T1D diagnosis and therefore may be largely influenced by the honeymoon period. However, 4/10 patients initially presented with diabetic ketoacidosis and the high HbA1c levels at diagnosis suggests this sample is typical of young adults with T1D.

Other recent large case series have described benefits of Semaglutide in patients who have both T1D and overweight or obesity, largely through its established effects on weight loss (1). The current paper suggests that Semaglutide may have more direct benefits on beta cell function – although baseline and changes in weight and BMI were not included in this brief report.

Reference: 1. Garg SK. et al. Efficacy of Semaglutide in Overweight and Obese Patients with Type 1 Diabetes. Diabetes Technol Ther. 2024 Mar;26(3):184–189. doi: 10.1089/dia.2023.0490. PMID: 38444317