Changes to insulin requirements over time with semaglutide in adults with type 1 diabetes on insulin pump therapy: A post‐hoc analysis of a double‐blinded, randomised, crossover trial
Authors' conclusion
Insulin needs decrease rapidly upon initiation of semaglutide use in type 1 diabetes on pump therapy, predominantly due to bolus changes from less carbohydrate consumption. While diabetes technology helps to reduce hypoglycemia, adjustments to pump dosing are still required.
Study context
- Population
- Adults with T1D on insulin pump therapy; 100% using continuous glucose monitoring (CGM) and 81% using automated insulin delivery (AID) at baseline
- Participants
- 26 adults
- Comparison
- Semaglutide vs placebo
- Primary endpoint
- Changes in insulin requirements, carbohydrate input and pump parameters over time vs baseline, and frequency of parameter adjustments
- Follow-up
- First 11 of 15 weeks; days 7, 21, 32, 56, 63 and 77
Methodological detailsdouble-blinded, Remote follow-ups on days 7, 21, 32, 56, 63 and 77 (± 4 days)
- Double-blinded
- Remote follow-ups on days 7, 21, 32, 56, 63 and 77 (± 4 days)
Primary result
As reported in the abstract
Insulin requirements, carbohydrate input and pump parameters vs baseline
Median increase in carbohydrate ratios by day 77
4.1%
−1.8, 7.7
Median increase in correction factors by day 77
11.2%
0.0, 20.8
Median reduction in pre-programmed basal rates by day 77
7.9%
−12.7, −4.2
Safety
Time in hypoglycaemia
- Median time spent in hypoglycemia rarely >4% during follow-ups
Original publication
Changes to insulin requirements over time with semaglutide in adults with type 1 diabetes on insulin pump therapy: A post‐hoc analysis of a double‐blinded, randomised, crossover trial. Diabetes Obes Metab. Published 27 October 2025. doi:10.
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