Efficacy and Safety of Glucagon‐Like Peptide‐1 Receptor Agonists as Adjuncts to Insulin Therapy in Type 1 Diabetes Mellitus: An Overlap‐Informed Umbrella Review
Authors' conclusion
Adjunctive GLP-1RA therapy was associated with a modest reduction in HbA1c and clinically relevant reductions in body weight and insulin requirements, without a significant improvement in time in range. Gastrointestinal adverse events were increased, whereas the risks of diabetic ketoacidosis and severe hypoglycemia remained uncertain.
Study context
- Population
- People with T1D on insulin; systematic reviews with meta-analyses including randomized controlled trials (RCTs) (alone or with nonrandomized studies)18 reviews · 56 primary studies
- Comparison
- Adjunctive GLP-1 RA therapy vs control in T1D
- Outcome
- HbA1c, body weight, total daily insulin dose and TIR
Methodological detailsoverlap-informed, random-effects reanalysis, AMSTAR 2, GRADE
- Overlap-informed
- Random-effects reanalysis
- AMSTAR 2
- GRADE
Pooled result
As reported in the abstract
GLP-1RAMD, % (95% CI)
HbA1c; moderate certainty
−0.23(−0.30 to −0.17)
GLP-1RAMD, kg (95% CI)
Body weight; moderate certainty
−3.93(−4.29 to −3.56)
GLP-1RAMD, IU/day (95% CI)
Total daily insulin dose; low certainty
−5.74(−7.30 to −4.17)
- No significant improvement in TIR (very low certainty)
- MD, 1.99% [95% CI, −1.17 to 5.15]
Safety
Adverse events
| RR (95% CI) | ||
|---|---|---|
| GLP-1RANausea; high certainty | 2.88 (2.20–3.76) | |
| GLP-1RAVomiting; high certainty | 3.11 (1.94–4.97) | |
| GLP-1RAWithdrawal due to adverse events; high certainty | 2.10 (1.42–3.12) | |
| GLP-1RADiarrhoea, not significantly increased; low certainty | 1.88 (0.82–4.33) | |
| 0.20.5125Relative risk (log scale) |
- Adverse events — No statistically significant increase in severe hypoglycaemia (low certainty)
- RR, 0.83 [95% CI, 0.36-1.91]
- Adverse events — No statistically significant increase in DKA (low certainty)
- RR, 0.67 [95% CI, 0.16-2.86]
Original publication
Efficacy and Safety of Glucagon‐Like Peptide‐1 Receptor Agonists as Adjuncts to Insulin Therapy in Type 1 Diabetes Mellitus: An Overlap‐Informed Umbrella Review. Diabetes Obes Metab. Published 10 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →