There’s no question about the popularity of GLP-1 weight loss drugs like Ozempic and Wegovy, but some doctors are worried the drugs are not intended for everyone and may be used by some patients who could face safety issues.
A study by the Johns Hopkins Bloomberg School of Public Health found a significant increase in the use of these drugs among people with type 1 diabetes, despite limited safety and effectiveness data for this patient group.
GLP-1 receptor agonists, initially developed for type 2 diabetes, have gained traction for weight loss and cardiovascular risk reduction. However, doctors say their use in type 1 diabetes patients raises concerns due to the potential for hypoglycemia, a dangerous low-blood sugar condition.
The study, published in Diabetes, Obesity and Metabolism, analyzed over 200,000 de-identified medical records of type 1 diabetes patients from 2008 to 2023. Key findings include:
Rising obesity rates: Obesity prevalence among type 1 diabetes patients increased significantly across all age groups and ethnicities. Among adults (20 and older), obesity rates increased from 30% in 2008-2011 to 38% in 2020-2023. For youth (2-19 years old), rates increased from 18% to 26% during the same time period.
Increased GLP-1 use: The proportion of adults with type 1 diabetes and severe obesity using GLP-1 receptor agonists jumped from approximately 4% in 2008-2011 to 33% in 2020-2023. Among severely obese youth, the increase was from less than 3% to 21%.
Specific drug trends: The use of semaglutide and tirzepatide, potent GLP-1 receptor agonists, has seen a substantial rise in recent years.
Patient population: The study utilized data from 217,442 patients with type 1 diabetes across more than 30 U.S. health systems.
A need for better data
"These findings highlight the urgent need for better data—including clinical trials—on the effectiveness and safety of GLP-1 receptor agonists in people with type 1 diabetes, to inform clear guidelines on their use in these patients," Dr. Jung-Im Shin, senior author of the study, said in a press release.
The researchers are now conducting further studies to quantify the risk of serious hypoglycemia associated with GLP-1 receptor agonist use in type 1 diabetes patients.