Effect of Semaglutide on Insulin Dose Reduction in Adults With Type 1 Diabetes and Obesity Using Automated Insulin Delivery Systems: ADJUST-T1D Post Hoc Analysis
Authors' conclusion
Semaglutide produced rapid, sustained, and primarily bolus-driven insulin dose reductions, with early effects being largely independent of weight loss in adults with T1D and obesity.
Study context
- Population
- Adults with T1D and obesity using AID systems
- Comparison
- Semaglutide 1 mg/week vs placebo
- Primary endpoint
- Relationship between insulin dose reduction and weight loss; change in total daily insulin dose (TDD)
- Follow-up
- 26 weeks
Methodological detailsdouble-blind, multicentre, placebo-controlled, linear mixed models, mediation analysis
- Double-blind
- Multicentre
- Placebo-controlled
- Linear mixed models
- Mediation analysis
Primary result
As reported in the abstract
Reduction in TDD · baseline to week 26
Reduction in TDD
22.6%
95% CI −28.3 to −17.0
Further findings
Bolus and basal insulin reduction · baseline to week 26
- Bolus insulin
- −30.5% (95% CI −39.5 to −21.5)
- Basal insulin
- −15.6% (95% CI −21.5 to −9.7)
Basal-to-TDD ratio and insulin dose (units/kg/day), Semaglutide · baseline to week 26
- Basal-to-TDD ratio increased
- 0.56 to 0.62 (P < 0.001)
- Insulin dose (units/kg/day) decreased
- 0.72 to 0.60 (P < 0.001)
Mediation of TDD reduction: direct drug effect vs weight loss · week 4 and week 26
- Week 4, direct drug effect
- 83% (−11.1 units/day)
- Week 4, weight loss
- 17% (−2.3 units/day)
- Week 26, direct effect
- −11.4 units/day; 52%
- Week 26, weight loss
- −10.5 units/day; 48%
Daily carbohydrate intake · baseline to 26 weeks
g
- Baseline
- 137 (95% CI 107-167)
- 26 weeks
- 107 (95% CI 76-137)
Original publication
Effect of Semaglutide on Insulin Dose Reduction in Adults With Type 1 Diabetes and Obesity Using Automated Insulin Delivery Systems: ADJUST-T1D Post Hoc Analysis. Diabetes Care. Published 22 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →