Introduction and Objective: The benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RA’s) have been well-documented for adults with type 2 diabetes mellitus. However, they are not considered standard of care for patients with type 1 diabetes mellitus (T1DM). This study seeks to assess the impact of GLP-1 RA’s on hemoglobin A1c levels, body mass index, lipid profiles, and atherosclerotic cardiovascular risk profiles in patients with T1DM. Methods: We conducted a retrospective query of the electronic medical record to identify adults with T1DM treated with insulin monotherapy or a GLP-1 RA with or without insulin. Eligible patients were ≥18 years old and had documented prescriptions for GLP-1 RA’s and/or insulin. Cases with cardiovascular conditions or prescriptions for non-insulin/non-GLP1 RA medications to treat type 2 diabetes were excluded. Changes in HbA1c, BMI, lipid profile, and ASCVD risk prior to and after 12 months of use of GLP-1 RA’s were compared using paired t-tests. Results: Across 623 T1DM patients, GLP-1 RA use was associated with significant glycemic, weight, and lipid improvements over 12 months. Mean HbA1c decreased from 7.8% to 7.3% (p0.001), with a higher proportion achieving HbA1c ≤7%. Mean BMI declined from 32.6 to 31.1 kg/m² (p0.001), reflecting reduced obesity severity. Total cholesterol decreased from 173.6 to 166.5 (p= 0.01) and LDL decreased from 96.7 to 90.7 (p=0.01). In contrast, HDL levels did not increase, and there was no significant reduction in ASCVD, suggesting that changes in cardiovascular disease risk may take longer to emerge. Conclusion: GLP-1 RA use in T1DM offers metabolic benefits, including a reduction in A1c, weight, and LDL levels. However, no significant reduction in ASCVD risk was observed over a 12-month period. While the improvements in lipid profiles are encouraging, substantial cardiovascular risk reduction will likely require longer follow-up or further risk-factor management to translate into measurable outcomes. Disclosure M. Nassiri: None.
Mushgan Nassiri (Fri,) studied this question.