There is substantial interest in the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 1 diabetes, but data on the long-term clinical outcomes are lacking. Using national electronic health record data from 174,678 patients with type 1 diabetes, we conducted a sequential target trial emulation from January 2013 to March 2024. After propensity score weighting, GLP-1RA initiation was associated with significantly lower risks of major adverse cardiovascular events (5-year risk: 4.3% versus 5.0%; risk difference: −0.7% (95% confidence interval (CI): −1.2% to −0.2%); hazard ratio (HR): 0.85 (0.77–0.95)) and end-stage kidney disease (5-year risk: 1.6% versus 1.9%; risk difference: −0.3% (−0.6% to 0%); HR: 0.81 (0.69–0.95)). No increased risks of hospitalization for diabetic ketoacidosis or severe hypoglycemia were observed. These findings suggest that GLP-1RAs may be beneficial against major adverse cardiorenal events in patients with type 1 diabetes, without compromising safety. A trial emulation study using electronic health record data from 174,678 patients with type 1 diabetes revealed that GLP-1RA initiation is associated with reduced risk of major cardiovascular events and end-stage kidney disease.
“Very important data that have been largely missing so far 🤓Similar MACE reduction as in T2DM (15 %) and 19 % reduction in end stage kidney disease 🤓No increase risk of severe side effects such as ketoacidosis or severe hypoglycemia 🤓I believe that the time has come to officially recommend use of GLP-1 RAs in type 1 diabetes patients. It is safe and very likely cardo- and nephroprotective”
Key implication: If confirmed, GLP-1RAs could become a standard adjunct therapy in selected T1D patients (especially those with obesity, high CV risk or CKD) for cardiorenal protection without added acute safety risks, potentially expanding their use beyond T2D.
Published mid-March 2026 coinciding with multiple media stories on GLP-1 benefits; CNN and other outlets covered related stopping study March 18; high social and news amplification (~15+ media articles).
Key implication: If confirmed, GLP-1RAs could become a standard adjunct therapy in selected T1D patients (especially those with obesity, high CV risk or CKD) for cardiorenal protection without added acute safety risks, potentially expanding their use beyond T2D.
XU et al. (2026) studied this question.