GLP-1 is a multifaceted hormone, and the use of its analogs is associated with broad metabolic effects: they increase insulin secretion, decrease glucagon release, increase glucose uptake in muscles, decrease glucose production in the liver, improve lipid profile, slow gastric emptying, and increase satiety leading to weight loss ( GLP-1RA have been used to treat T2D for ~20 years, and they have transformed T2D management in pediatric and adult populations ( 4.1 HbA1c reduction 4.1.1 Uncontrolled studies In a small, uncontrolled study, weekly semaglutide in 10 patients with newly diagnosed T1D, mean HbA1c improved dramatically from 11.7 2.1% to 5.7 0.4% at 12 months ( 4.1.2 RCTs Several blinded, placebo-controlled RCTs have demonstrated a significant reduction in HbA1c when adding GLP-1RA to either multiple daily injections (MDI) or continuous subcutaneous infusion of insulin (CSII), ranging between 0.1-0.7% (61) ( Table 1 )
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