Diabetes 101 - Lesson 9: T1D & GLP-1s
- James Northcutt
- Aug 15
- 4 min read
Updated: Aug 22
Type 1 Diabetes & GLP-1s: Benefits, Side Effects, and Tips from eddii-Care
You might’ve seen more and more chatter lately about people with type 1 diabetes (T1D) trying GLP-1 receptor agonists (medications like Ozempic and Mounjaro) to help with blood sugar control, weight management, and even insulin needs. But what’s the real story here? And should you be considering them? Here’s everything you need to know!
First things first: What are GLP-1s and how do they work?
GLP-1 receptor agonists are a class of medications originally designed for people with type 2 diabetes. They work by mimicking the effects of a hormone called glucagon-like peptide-1, which helps regulate blood sugar levels, slows digestion, and can reduce appetite. While they’re not approved by the FDA for type 1 diabetes, some endocrinologists prescribe them “off-label” for certain patients.
Why are people talking about GLP1s for T1D?
Some early research and real-world experiences suggest that GLP-1s may:
Reduce daily insulin needs
Help smooth out post-meal blood sugar spikes
Support weight loss, which can improve insulin sensitivity
A 2023 study in Diabetes Care found that people with T1D who added a GLP-1 saw modest improvements in time-in-range and body weight. But the benefits weren’t universal, and not everyone tolerated the meds well, which is part of why GLP-1s are not yet FDA-approved for people living with type 1 diabetes.
Are GLP1-s right for me?
While most T1D patients are unlikely to benefit, some possible candidates include:
Those with T1D plus obesity or insulin resistance
People with residual C-peptide (indicating some beta-cell function)
Carefully selected patients after specialist evaluation
Managing potential risks and side effects of taking GLP-1s
Like any medication, GLP-1s come with potential downsides. Common side effects include nausea, vomiting, diarrhea, and constipation, especially when starting treatment. There’s also the risk of hypoglycemia if insulin doses aren’t adjusted carefully. And because GLP-1s slow digestion, they may not be a good fit for people with gastroparesis (a condition that’s more common in diabetes).
Safety & monitoring: What you need to know
Before trying GLP-1s, consider this checklist:
DKA Risk: Rapid insulin dose reduction can trigger DKA. Titrate insulin slowly and monitor ketones, especially during dose changes.
Gastrointestinal Effects: Nausea, vomiting, diarrhea, or constipation are common. Start with small menued portions, stay hydrated, and titrate dose gradually.
Pancreatitis & Thyroid: If you have personal or family history of medullary thyroid carcinoma (or MEN2), or a history of pancreatitis, GLP-1s may be harmful.
Insulin Pumps / AID Systems: Close glucose and ketone monitoring is vital when adjusting insulin pump or hybrid closed-loop settings.
Tips for thriving on GLP-1 therapy
Eat smaller, slower meals to reduce GI side effects.
Start low, go slow: titrate the GLP-1 dose gradually.
Monitor glucose and ketones frequently, especially during dose changes.
Keep fast-acting carbs handy and contact your provider if persistent nausea or ketones appear.
Have a clear insulin adjustment plan: don’t reduce by more than 10-20% at a time, unless guided by your care team.
What does the evidence say?
Here’s a snapshot of current T1D research as published in Diabetes Care and Frontiers in Endocrinology.
Outcome | Findings |
HbA₁c / Glucose control | A1c may modestly decrease in some individuals |
Insulin dose | Total daily insulin requirement tends to drop |
Weight management | Modest weight loss often reported |
CV/kidney protection | Benefits seen in T2D; no conclusive evidence for T1D yet |
How eddii-Care can help you safely explore GLP-1s
At eddii-Care, our board-certified endocrinologists and care team specialize in managing the nuances of combining insulin therapy with GLP-1s.
We help you:
Assess whether adding a GLP-1 makes sense for your metabolic profile
Create a stepwise, safe insulin adjustment and monitoring plan
Support with GI strategies, ketone monitoring, and dosing schedules
Ensure ongoing evaluation to minimize risk and maximize benefit
Ready to take the next step? Book a virtual appointment to discuss GLP-1 suitability, safety planning, and personalized care with an eddii-Care provider.
The bottom line
GLP-1s aren’t a magic fix, and they’re not right for everyone with T1D. If you’re curious, talk to your endocrinologist, preferably one who’s familiar with both type 1 diabetes and GLP-1 medications. They can help weigh the potential benefits and risks based on your specific health profile. Your eddii-Care endocrinologist is a great resource for this. Schedule an appointment today!
FAQ: Quick Answers
Q: Are GLP-1s approved for Type 1 diabetes?
A: No. GLP-1 receptor agonists are not FDA-approved for T1D; their use is off-label. Refer to a specialist before pursuing this option.
Q: Can GLP-1s replace insulin in T1D?
A: No. Even with some residual beta-cell function, GLP-1s are only an adjunct - not a replacement - for insulin.
Q: Do GLP-1s cause DKA?
A: Not directly, but reducing insulin too rapidly while on GLP-1s has been associated with DKA in case reports. Slow insulin titration and ketone monitoring are essential.
Q: Do GLP-1s improve heart and kidney outcomes in T1D?
A: Benefits are well-established in Type 2 diabetes, but no conclusive evidence yet exists for T1D.
Q: As a T1D, are GLP-1s covered by my insurance?
A: It depends on your overall health condition and specific situation. You can speak with your eddii-Care endocrinologist and care team to better understand if you you'd be covered by your insurance.
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