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* Edit Profile * Manage Subscriptions * CME Tracker * Log Out Login Sign Up search Search * Specialties Back * Allergy & Immunology * Anesthesiology * Cardiology * Critical Care * Dermatology * Emergency Medicine * Endocrinology * Gastroenterology * Genetics * Geriatrics * HIV / AIDS * Hospital-Based Medicine * Infectious Disease * Nephrology * Neurology * Nursing * OB / GYN * Oncology / Hematology * Ophthalmology * Orthopedics * Pain Management * Pathology * Pediatrics * Pharmacy * Primary Care * Psychiatry * Pulmonology * Radiology * Rheumatology * Surgery * Transplantation * Urology * Perspectives * Health Policy * Meetings * Special Reports * Break Room * Conditions Back * Condition Centers * Making the Rounds * Medical Journeys * Society Partners Back * AAD Reading Room * ACR Reading Room * AGA Reading Room * ASCO Reading Room * Endocrine Society Reading Room * IDSA Reading Room * CME * Healthcare Jobs * Synopsi Endocrinology > Type 1 Diabetes LOW-DOSE SEMAGLUTIDE CAN EASE INSULIN NEED IN EARLY T1D, SMALL SERIES SHOWS — ALL 10 PATIENTS WERE ABLE TO ELIMINATE PRANDIAL INSULIN USE WITHIN 3 MONTHS by Kristen Monaco, Senior Staff Writer, MedPage Today September 6, 2023 MedpageToday Share on Facebook. Opens in a new tab or window Share on X. Opens in a new tab or window Share on LinkedIn. Opens in a new tab or window email article When used very early on in type 1 diabetes, a GLP-1 receptor agonist may help reduce the need for insulin, a small case series suggested. Ten adults with a new type 1 diabetes diagnosis initially received a 0.125-mg dose of weekly semaglutide (Ozempic), which was adjusted up to a maximum of 0.5 mg per week as prandial insulin was adjusted down. Within 3 months of starting semaglutide, all of the patients were completely off prandial insulin. Within 6 months, seven patients were also able to eliminate basal insulin, reported Paresh Dandona, MD, PhD, of the State University of New York at Buffalo in Williamsville, New York, and colleagues, who detailed their findings in a New England Journal of Medicineopens in a new tab or window correspondence. "In all, our preliminary observations support the need for prospective, randomized clinical trials with larger numbers of patients to investigate this approach further," the researchers suggested. Though widely used for type 2 diabetes and obesity, no GLP-1 receptor agonists or SGLT2 inhibitors are currently approved by the FDA for type 1 diabetes. While some agents have been submitted to the agencyopens in a new tab or window for review, none have actually nabbed a type 1 diabetes indication, often due to concerns about diabetic ketoacidosis and hypoglycemia from the agents' dramatic glucose lowering capabilities. The current case series followed patients ages 21 to 39 at the State University of New York at Buffalo from 2020 to 2022. Half were female, all but one were white, and their average baseline body mass index was 25.1. Four initially presented with diabetic ketoacidosis at the time of diagnosis while the others presented with polyuria, polydipsia, and weight loss. A total of nine patients had antibodies against glutamic acid decarboxylase, and one had autoantibodies against islet antigen 2. Patients were started on semaglutide within 3 months of their diagnosis, as "most patients with new-onset type 1 diabetes have substantial intact beta-cell reserve," the researchers noted. While medication doses were being adjusted, carbohydrate intake was restricted for all patients. Mean HbA1c dropped from 11.7±2.1% at baseline down to 5.9±0.3% by the 6-month mark of semaglutide treatment. This continued to drop a bit more, falling to 5.7±0.4% at 12 months. Patients on semaglutide also saw a significant rise in mean fasting C-peptide levels, from 0.65±0.33 ng/mL at baseline up to 1.05±0.40 ng/mL by the end of the study and patients spent 89±3% of time in range as measured by continuous glucose monitoring. MEDICAL NEWS FROM AROUND THE WEB STAT 1 The WHO and drug regulators want to reformulate the flu vaccine. It’s easier said than done opens in a new tab or window KevinMD.com 2 Why new cancer treatments cannot save us opens in a new tab or window CNN 3 It’s not just ‘Sephora kids.’ 20-somethings are paying up for cosmetic procedures to prevent aging | CNN opens in a new tab or window As they had no control arm, the researchers compared their HbA1c data with the control groups of four studies involving patients with early type 1 diabetes, where initial improvement in HbA1c was only observed during the first 6 months. "Thereafter, they all showed an increase in the glycated hemoglobin level, a finding that was consistent with the end of the so-called 'honeymoon period' in the treatment of early type 1 diabetes," Dandona and coauthors wrote. As is the concern in type 1 diabetes, the researchers pointed out that only mild hypoglycemia was seen during the semaglutide dose titration. After the dose was stabilized, none of the patients experienced any episodes of hypoglycemia. Likewise, there were no events of diabetic ketoacidosis or other serious adverse events. At baseline, the average total insulin dose was 0.35±0.11 U/kg, while basal and bolus insulin doses were 0.21±0.12 U/kg and 0.15±0.09 U/kg, respectively. * Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015. Disclosures Dandona reported no disclosures. A co-author reported relationships with Eli Lilly and Novo Nordisk. Primary Source New England Journal of Medicine Source Reference: opens in a new tab or windowDandona P, et al "Semaglutide in early type 1 diabetes" N Engl J Med 2023; DOI: 10.1056/NEJMc2302677. Share on Facebook. Opens in a new tab or window Share on X. Opens in a new tab or window Share on LinkedIn. Opens in a new tab or window email article 3 Comments Please enable JavaScript to view the comments powered by Disqus. MEDICAL NEWS FROM AROUND THE WEB STAT 1 The WHO and drug regulators want to reformulate the flu vaccine. It’s easier said than done opens in a new tab or window KevinMD.com 2 Why new cancer treatments cannot save us opens in a new tab or window CNN 3 It’s not just ‘Sephora kids.’ 20-somethings are paying up for cosmetic procedures to prevent aging | CNN opens in a new tab or window MEDICAL NEWS FROM AROUND THE WEB STAT 1 The WHO and drug regulators want to reformulate the flu vaccine. It’s easier said than done opens in a new tab or window KevinMD.com 2 Why new cancer treatments cannot save us opens in a new tab or window CNN 3 It’s not just ‘Sephora kids.’ 20-somethings are paying up for cosmetic procedures to prevent aging | CNN opens in a new tab or window Forbes 4 The Hepatitis C Crisis Epitomizes The Problems With U.S. Healthcare opens in a new tab or window Pediatrics 5 Vaccine Effectiveness Against Long COVID in Children. opens in a new tab or window Annals of Internal Medicine 6 Gabapentinoids and Risk for Severe Exacerbation in Chronic Obstructive Pulmonary Disease : A Population-Based Cohort Study. opens in a new tab or window RECOMMENDED FOR YOU 1 Second Opinions How Should Health Plans Respond to Surging Interest in Weight Loss Drugs? 2 Primary Care FDA Clears Wegovy, Other GLP-1 Drugs of Suicidality Risk for Now 3 Primary Care More Kids Getting Their Hands on Nonprescription Weight-Loss Products 4 Rheumatology When Women's Fertility Begins and Ends Seems Important for RA Development 5 Oncology/Hematology More Evidence Linking ADT for Prostate Cancer to Adverse Neurocognitive Effects 6 Endocrinology T1D Trial Paused After Deaths; Mounjaro Not Just Cosmetic; Late-Stage Hot Flash Win Visit us on Facebook. 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