Safety of GLP-1 receptor agonists in type 1 diabetes: a systematic review and meta-analysis
Authors' conclusion
In conclusion, in pooled analyses, GLP-1 RAs were not associated with increased severe hypoglycaemia or DKA, although evidence remains limited.
Study context
- Population
- People with T1D; databases searched through June 202525 studies (23 RCTs, 2 observational)
- Comparison
- GLP-1 RA vs control
- Outcome
- Hypoglycaemia, serious AEs, severe hypoglycaemia and DKA (pooled)
Methodological detailsPRISMA guidelines
- PRISMA guidelines
Pooled result
As reported in the abstract
Overall hypoglycaemia, neutral risk (Moderate certainty)
RR 1.01
Serious adverse events, neutral risk (Moderate certainty)
RR 0.89
Severe hypoglycaemia, no significant increase (Low certainty)
RR 0.74
Diabetic ketoacidosis (DKA), no significant increase (Very Low certainty)
RR 0.60
Further pooled results
Tolerability by therapy duration (subgroup analysis) · after six months
- Overall tolerability significantly improves after six months of therapy
Safety
| Outcome | RR |
|---|---|
| Gastrointestinal adverse eventsGLP-1 RAs · Nausea | 2.89 |
| Gastrointestinal adverse eventsGLP-1 RAs · Vomiting | 3.10 |
| Early treatment withdrawalModerate certainty | 2.02 |
Original publication
Safety of GLP-1 receptor agonists in type 1 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract. Published 7 May 2026. doi:10.
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