For adolescents and young adults battling type 1 diabetes (T1D), even the most advanced insulin therapies often fall short of delivering stable glucose control. But what if a class of medications designed for type 2 diabetes and obesity could offer new hope? Recent research suggests that GLP-1 receptor agonists, such as semaglutide and tirzepatide, may do just that—helping patients achieve better glycemic outcomes, reduce insulin needs, and even lose weight.

A case series published in the Journal of Diabetes Science and Technology investigated the use of these medications as an off-label adjunct to insulin therapy for T1D. The findings showed significant benefits, including improved time-in-range (TIR) metrics, reduced glucose variability, and lower insulin requirements. Many patients also experienced meaningful weight loss, particularly those with concurrent obesity. Importantly, no cases of diabetic ketoacidosis were reported, underscoring the potential safety of this combination therapy.

However, the study also highlighted challenges. Gastrointestinal side effects, such as nausea and diarrhea, were common but typically improved with gradual dose titration. One patient developed an eating disorder, prompting careful consideration of the psychological impacts these medications might have. Additionally, medication shortages and insurance barriers disrupted treatment for several participants, spotlighting systemic hurdles to accessing these promising therapies.

Despite these challenges, GLP-1 receptor agonists appear to hold significant promise for T1D management, offering a path to better glucose control and long-term health outcomes. With ongoing research and systemic reforms to improve access, these medications could redefine how T1D is treated for future generations.