Hey readers! 👋
This week we're zooming in on a topic that's generating a lot of quiet buzz in the T1D community: GLP-1 receptor agonists and their potential role for people living with Type 1 diabetes. You know, those medications you keep hearing about for weight loss and T2D? Turns out, they're increasingly showing up in T1D conversations too, and the early signals are genuinely interesting. We've also got a packed week of cell therapy updates, a new genetic risk tool, and clinical trials worth knowing about. Let's dig in.
💉 GLP-1s and T1D: What We Know So Far
Ask the Expert: Diana Isaacs on Benefits, Risks, and Real-World Use of GLP-1s in T1D - A thorough expert Q&A exploring why GLP-1 receptor agonists like semaglutide and tirzepatide are being used off-label in T1D, what the real benefits look like, and where the risks hide. – Jewels Doskicz, T1D Exchange
This is probably the most important read of the week if you're curious about GLP-1s and T1D. Diana Isaacs lays out the landscape clearly: many people with T1D meet eligibility criteria for these drugs due to overweight or obesity, and real-world data suggests improvements in A1C, Time in Range, weight, and potentially cardiovascular and kidney health. But here's the critical nuance: appetite suppression from GLP-1s can mask DKA risk, even when glucose levels look normal.
"Glucose alone isn't always the best indicator of DKA."
That's a line worth remembering. If you're on a GLP-1 and experiencing nausea or reduced appetite, ketone monitoring becomes essential. Insulin adjustments need to be individualized, CGM support is important, and working with a dietitian can help prevent nutritional gaps and muscle loss. FDA approval for T1D hasn't been submitted yet, but use is growing, including via telehealth.
Teens With T1D, Obesity Reaped Benefits of GLP-1s, Case Studies Suggest - Two adolescents with T1D and obesity showed weight loss, reduced insulin needs, and improved glycemic metrics on low-dose semaglutide, with no severe adverse events over about a year. – MedPage Today
These case reports, published in Pediatrics, are small but telling. Both teens saw meaningful improvements with careful risk mitigation: CGM alerts, ketone checks, and gradual prandial insulin reduction. The authors are candid that larger trials are urgently needed, especially for dosing guidance in youth.
"These two cases illustrate the growing burden of obesity in adolescent out-patient clinics handling type 1 diabetes and the urgent need for evidence-based targeted interventions addressing both weight management and glycemic control in this challenging population."
The intersection of T1D and obesity in young people is a growing clinical reality, and GLP-1s may eventually become part of the toolkit, but we're not there yet in terms of formal evidence.
🔬 Cell Therapy and Transplant Updates
A Promising New Way to Transplant Cells Could Lead to Better Treatment for T1D - McGill University developed a bioartificial device that transplants insulin-producing cells via a pre-formed network of artificial blood vessels, providing immediate blood supply while reducing immune rejection. – McGill University Newsroom
This tackles one of the biggest problems in cell transplantation: early cell death from insufficient blood supply. The 3D-printed vascular channels are designed to nourish the graft immediately, and the platform could be manufactured, sterilized, and shipped globally for different cell types.
🧬 Genetics and Diagnostics
UC San Diego Study Uses Machine Learning to Dive Deeper into Diabetes Risk - A new machine learning tool called T1GRS captures complex gene interactions to predict T1D risk more accurately, identifying 79 risk loci (13 novel) and four genetic subtypes with distinct onset patterns. – The San Diego Union-Tribune
What's notable is the model works beyond European ancestry populations (87% accuracy in external datasets) and groups T1D into subtypes linked to different complication profiles. This could eventually support earlier screening and more personalized prevention.
"There's a lot of Type 1 diabetes that's not covered by that very, very early age and super-high-risk genetic variants."
🧪 Clinical Trials and Research
New Study Tests Drug's Ability to Reset Immune Balance in Newly Diagnosed T1D - TrialNet's RESET T1D study will test rezpegaldesleukin in 66 newly diagnosed participants, aiming to improve regulatory T cell function and preserve insulin production. – TrialNet
This is the first trial of this immune-targeting therapy in T1D, building on promising results in other autoimmune conditions. Enrollment starts with adults 18-45 and will expand to younger ages after safety review.
Breakthroughs in Type 1 Diabetes Research in 2025 - A comprehensive roundup of 2025's T1D research progress, from immune-evasive stem cells to the BASTA blood test for earlier detection. – Breakthrough T1D Australia
New-Onset T1D Trials Directory - A useful directory of immunotherapy trials for recently diagnosed individuals aiming to preserve beta cell function. – T1D Trials
Mayo Clinic T1D Clinical Trials - 74 active studies spanning diabetes tech, insulin regimens, biomarker discovery, and more. – Mayo Clinic Research
CXCL10 Identified as Potential Biomarker for LADA - A proteogenomic study found CXCL10 can distinguish LADA from T2D and healthy controls with high accuracy, potentially reducing misdiagnosis. – PubMed
⌚ Tech Corner
Tidepool-Powered twiist Loop - The first AID system powered by Tidepool technology, predicting glucose every 5 minutes with a six-hour forecast and Apple Watch integration. – Tidepool
That's your week! The GLP-1 conversation in T1D is still early, but it's moving fast, and staying informed about both the promise and the risks is exactly where we want to be. Until next time, take care of yourselves. 💙
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