They’re all over the news: Ozempic ®. Trulicity ®. Jardiance ®. Mounjaro ™. And more.
These drugs are all approved for glucose control in type 2 diabetes (T2D). Some of them also have additional indications reflecting their demonstrated benefits for cardiovascular disease, kidney health, and obesity. None of them are approved for people with type 1 diabetes (T1D).
But did you know that many of these medications have origins in Breakthrough T1D-funded research? And that Breakthrough T1D is funding new research to investigate whether some of these drugs can also have the same benefits for people with T1D?
Let’s take a look at GLP-1 therapies and SGLT inhibitors and how drugs like Ozempic may one day be able to help people with T1D.
GLP-1 therapies
GLP-1 (glucagon-like peptide-1) receptor agonists work in multiple ways to control blood glucose and obesity. They block the release of glucagon, stimulate insulin production, slow the rate at which your stomach empties, and increase the sensation of feeling full. They are usually injected, but there are oral versions available.
In people with T2D, this class of drugs lowers blood-sugar levels and, for most people, causes weight loss. GLP-1 therapies have also been shown to reduce the risk of long-term cardiovascular complications often experienced by people with T2D such as heart attack and stroke.
GLP-1 drugs include Ozempic/Rybelsus/Wegovy (semaglutide), Trulicity (dulaglutide), Victoza (liraglutide), and Mounjaro (tirzepatide), among others.
When GLP-1 treatments hit the market in the early 2000s, researchers wanted to know if they would also work for people with T1D. Breakthrough T1D and others funded several clinical trials to test whether GLP-1 receptor agonists, in addition to insulin, improved outcomes. While some of these studies showed that the addition of GLP-1 therapies to insulin led to improvements in HbA1c, total insulin dose, and weight, the benefits were relatively modest and accompanied by some side effects like hypoglycemia. As a result, these studies did not lead to GLP-1 receptor agonists being highly adopted for use by people with T1D.
However, these trials were done with older GLP-1 drugs. Whether the newest, most advanced GLP-1 therapies (like Ozempic) will improve T1D health is an open question that we are investigating. (See below!)
SGLT inhibitors
SGLT (sodium-glucose co-transporter) inhibitors are oral medications for people with T2D that lower blood sugar by preventing the kidneys from reabsorbing glucose, leading to the excretion of sugar through the urine.
In addition to improving blood sugar for people with and without T2D, these drugs also provide benefits such as weight loss, blood pressure reduction, and transformative benefits to the heart and kidneys.
SGLT drugs include Jardiance (empagliflozin), Farxiga (dapagliflozin), and Invokana (canagliflozin), among others.
Despite demonstrating improved glucose control for people with T1D, SGLTs have not been approved for people with T1D in the U.S. Increased risk of diabetic ketoacidosis (DKA) in this population limits the use of these therapies. A key Breakthrough T1D priority is to find ways to mitigate this risk so people with T1D can also take advantage of the SGLT cardiovascular and renal benefits.
JDRF-funded research in GLP-1 and SGLT therapies
Breakthrough T1D has a long history with GLP-1 medications like Ozempic. In the 1980s, Breakthrough T1D-funded researcher Pauline Kay Lund, Ph.D., was the first to clone the hormone glucagon and discover two new hormones, one of which was GLP-1.
Previous Breakthrough T1D-funded trials with GLP-1 agonists used earlier generations of therapies from this drug class. But Breakthrough T1D is always eager to evaluate the newest, most promising diabetes medications in people with T1D, and so our work here continues!
For example, JDRF-funded research led by Dr. Viral Shah at the Barbara Davis Center at the University of Colorado—and in collaboration with three other leading diabetes centers (Henry Ford Hospital, Iowa Diabetes, and the Oregon Health & Science University)—is investigating ways semaglutide (Ozempic) may benefit people with T1D and obesity who are using artificial pancreas (AP) systems.
JDRF-funded researchers have also started to explore the potential benefit of combining an SGLT inhibitor with GLP-1 therapy. A separate Breakthrough T1D-funded clinical trial is studying the effects of triple therapy: a GLP-1 receptor agonist (semaglutide/Ozempic) plus an SGLT inhibitor (dapagliflozin/Farxiga), in combination with insulin therapy. Investigators hope to learn if this multi-drug approach can help people with T1D achieve superior blood sugar levels.
Our commitment to improving lives
Breakthrough T1D strives to improve health outcomes in people with T1D. Insulin therapy alone is often not enough for people with T1D to achieve glucose and metabolic control. The use of adjunctive drugs that complement insulin therapy can help. Since the FDA has already approved these medications for treating other conditions, positive results from these clinical trials could speed up the adaptation of these therapies for people living with T1D.
Learn more about Breakthrough T1D’s contributions to GLP-1 treatments.
Editor’s note: How you manage your type 1 diabetes is a personal decision that should be made by you and your healthcare team. Breakthrough T1D content is for informational purposes only and is not a substitute for professional medical advice. Please contact your doctor or other qualified health provider with any questions you may have regarding type 1 diabetes or any medical condition.
