Real-World Evidence of the Effect of Adjunctive Semaglutide on Weight Change, Glycemic Control, and Metabolic Dysfunction-Associated Steatotic Liver Disease in People with Type 1 Diabetes
Authors' conclusion
Semaglutide in T1D was safe and well-tolerated and led to significant weight loss, improved glycemic control, and amelioration of MASLD.
Study context
- Population
- Overweight/obese adults with T1D with stable hemoglobin A1c (HbA1c), body weight and TDI over the preceding year; 53% male, age 46 ± 12 years, diabetes duration 28 ± 12 years, HbA1c 7.4 ± 0.8%, BMI 32.2 ± 4.3 kg/m²; 76.2% obese8 discontinued
- Participants
- 42 adults
- Exposure
- Once-weekly semaglutide, 12 months vs baseline
- Semaglutiden = 42
- Outcome
- Relative weight change
- Follow-up
- 12 months
Methodological detailssingle-group, 12-month follow-up
- Single-group
- 12-month follow-up
Main finding
As reported in the abstract
Mean relative weight loss
13.3 ± 11.3%
P < 0.001
Attaining ≥5% weight loss
76.4%
Attaining ≥10% weight loss
61.7%
Observational data: associations, not effects.
Further findings
HbA1c change · 12 months
- HbA1c decrease
- 0.4 ± 0.6% (P < 0.001)
- Reduction of ≥0.5%
- 42%
Obesity prevalence · 12 months
- Obesity prevalence decreased from 76.2% to
- 29.4% (P < 0.001)
TDI change · 12 months
- TDI reduction
- 13.6 ± 16.0% (P < 0.001)
- TDI/kg body weight
- TDI/kg of body weight remained stable
CGM-derived parameters · 12 months
- No significant changes in CGM-derived parameters
- n = 28 with available data
MASLD prevalence (serial hepatic imaging) · 12 months
- MASLD prevalence, baseline to 12 months
- 82.6% to 30.4% (P < 0.001)
- Controlled attenuation parameter (CAP) decrease
- 45 ± 33 decibels/m
- Significant fibrosis (liver stiffness measurement (LSM) >8 kPa)
- 20.6% to 4.5% (P < 0.001)
- n = 23 with serial hepatic imaging
Safety
Treatment discontinuation
- Discontinued treatment, mainly due to gastrointestinal intolerance
- 8 subjects
Original publication
Real-World Evidence of the Effect of Adjunctive Semaglutide on Weight Change, Glycemic Control, and Metabolic Dysfunction-Associated Steatotic Liver Disease in People with Type 1 Diabetes. Diabetes Technol Ther. Published 24 July 2025. doi:10.
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