Diabetes care · 2026
Effect of Semaglutide on Insulin Dose Reduction in Adults With Type 1 Diabetes and Obesity Using Automated Insulin Delivery Systems: ADJUST-T1D Post Hoc Analysis.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Karakus Kagan E, Akturk Halis K, Kruger Davida, Ahmann Andrew, Bharvaga Anuj, Langel Christine R, Ackeifi Courtney A, Rosen Jonathan, Pyle Laura, Snell-Bergeon Janet K, Shah Viral N
Аннотация
OBJECTIVE: In this post hoc analysis, we used the data from the Adjunct Semaglutide Treatment in Type 1 Diabetes (ADJUST-T1D) trial, a double-blind, multicenter, randomized, placebo-controlled trial of semaglutide 1 mg/week in adults with type 1 diabetes (T1D) and obesity, to evaluate the relationship between insulin dose reduction and weight loss.
RESEARCH DESIGN AND METHODS: Changes between semaglutide and placebo groups over 26 weeks in total daily insulin dose (TDD), basal and bolus insulin doses, carbohydrate intake, and user-initiated bolus counts were analyzed using linear mixed models. Mediation analysis was used to attribute direct effects of semaglutide versus weight loss on insulin dose reduction.
RESULTS: From baseline to week 26, there was a significant 22.6% reduction in TDD (95% CI -28.3 to -17.0), which was driven by greater reductions in bolus insulin (-30.5%; 95% CI -39.5 to -21.5) than basal insulin (-15.6%; 95% CI -21.5 to -9.7). The basal-to-TDD ratio increased from 0.56 to 0.62 (P < 0.001) and insulin dose (in units/kg/day) decreased from 0.72 to 0.60 (P < 0.001) in the semaglutide group. At week 4, an 83% (-11.1 units/day) reduction in TDD was due to a direct drug effect, and 17% (-2.3 units/day) was attributed to weight loss, whereas at week 26, the difference was split evenly between direct effect (-11.4 units/day; 52%) and weight loss (-10.5 units/day; 48%). Daily carbohydrate intake decreased from 137 g (95% CI 107-167) at baseline to 107 g (95% CI 76-137) at 26 weeks.
CONCLUSIONS: Semaglutide produced rapid, sustained, and primarily bolus-driven insulin dose reductions, with early effects being largely independent of weight loss in adults with T1D and obesity.
RESEARCH DESIGN AND METHODS: Changes between semaglutide and placebo groups over 26 weeks in total daily insulin dose (TDD), basal and bolus insulin doses, carbohydrate intake, and user-initiated bolus counts were analyzed using linear mixed models. Mediation analysis was used to attribute direct effects of semaglutide versus weight loss on insulin dose reduction.
RESULTS: From baseline to week 26, there was a significant 22.6% reduction in TDD (95% CI -28.3 to -17.0), which was driven by greater reductions in bolus insulin (-30.5%; 95% CI -39.5 to -21.5) than basal insulin (-15.6%; 95% CI -21.5 to -9.7). The basal-to-TDD ratio increased from 0.56 to 0.62 (P < 0.001) and insulin dose (in units/kg/day) decreased from 0.72 to 0.60 (P < 0.001) in the semaglutide group. At week 4, an 83% (-11.1 units/day) reduction in TDD was due to a direct drug effect, and 17% (-2.3 units/day) was attributed to weight loss, whereas at week 26, the difference was split evenly between direct effect (-11.4 units/day; 52%) and weight loss (-10.5 units/day; 48%). Daily carbohydrate intake decreased from 137 g (95% CI 107-167) at baseline to 107 g (95% CI 76-137) at 26 weeks.
CONCLUSIONS: Semaglutide produced rapid, sustained, and primarily bolus-driven insulin dose reductions, with early effects being largely independent of weight loss in adults with T1D and obesity.