About The Study: Prescribing for both glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 (SGLT2) inhibitors in a type 1 diabetes (T1D) population identified in a database increased between 2010 and 2023. Differences in characteristics of the overall T1D population and those newly prescribed the medications are often associated with elevated cardiorenal risk profiles, suggesting use of these newer treatments was intended to address additional medical needs. Concerns about euglycemic diabetic ketoacidosis led to the removal of SGLT2 inhibitors for T1D in Europe, and the U.S. Food and Drug Administration has not approved their use in T1D.
Quote from corresponding author Hui Shao, MD, PhD:
“Despite concerns that GLP-1 receptor agonists and SGLT2 inhibitors may cause serious adverse events such as ketoacidosis, the use of these medications in type 1 diabetes (T1D) has sharply increased over the past decade. This increase is likely to continue due to their significant benefits in weight management and cardiorenal protection observed in individuals with type 2 diabetes and the general obese population.
“Urgent studies are needed to evaluate the efficacy and safety of GLP-1RAs and SGLT2 inhibitors in the T1D population. Before such evidence becomes available, caution should be used when prescribing these treatments to individuals with T1D.”
Contact information for Hui Shao, MD, PhD: email hui.shao@emory.edu.)
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(doi:10.1001/jama.2024.18581)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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