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<p>There is substantial interest in the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 1 diabetes, but data on the long-term clinical outcomes are lacking. Using national electronic health record data from 174,678 patients with type 1 diabetes, we conducted a sequential target trial emulation from January 2013 to March 2024. After propensity score weighting, GLP-1RA initiation was associated with significantly lower risks of major adverse cardiovascular events (5-year risk: 4.3% versus 5.0%; risk difference: −0.7% (95% confidence interval (CI): −1.2% to −0.2%); hazard ratio (HR): 0.85 (0.77–0.95)) and end-stage kidney disease (5-year risk: 1.6% versus 1.9%; risk difference: −0.3% (−0.6% to 0%); HR: 0.81 (0.69–0.95)). No increased risks of hospitalization for diabetic ketoacidosis or severe hypoglycemia were observed. These findings suggest that GLP-1RAs may be beneficial against major adverse cardiorenal events in patients with type 1 diabetes, without compromising safety.</p>

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Glucagon-like peptide-1 receptor agonists for major cardiovascular and kidney outcomes in type 1 diabetes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月19日

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  • Yunwen Xu,
  • Natalie Daya Malek,
  • Alexander R. Chang,
  • Justin B. Echouffo-Tcheugui,
  • Elizabeth Selvin,
  • Morgan E. Grams,
  • Michael Fang,
  • Jung-Im Shin

摘要

There is substantial interest in the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 1 diabetes, but data on the long-term clinical outcomes are lacking. Using national electronic health record data from 174,678 patients with type 1 diabetes, we conducted a sequential target trial emulation from January 2013 to March 2024. After propensity score weighting, GLP-1RA initiation was associated with significantly lower risks of major adverse cardiovascular events (5-year risk: 4.3% versus 5.0%; risk difference: −0.7% (95% confidence interval (CI): −1.2% to −0.2%); hazard ratio (HR): 0.85 (0.77–0.95)) and end-stage kidney disease (5-year risk: 1.6% versus 1.9%; risk difference: −0.3% (−0.6% to 0%); HR: 0.81 (0.69–0.95)). No increased risks of hospitalization for diabetic ketoacidosis or severe hypoglycemia were observed. These findings suggest that GLP-1RAs may be beneficial against major adverse cardiorenal events in patients with type 1 diabetes, without compromising safety.