GLP-1 Receptor Agonists May Reduce Insulin Requirements in New-Onset Type 1 Diabetes.

Early stage 3 type 1 diabetes is a period of rapid pathophysiologic change. Flagging beta-cell secretion is accompanied by postprandial hyperglucagonemia, impaired incretin amplification, beta-cell stress, and insulin resistance. Incretin-based therapy may align favorably with these defects by augmenting glucose-dependent insulin secretion, improving postprandial hyperglucagonemia, reducing beta-cell stress and insulin resistance. Randomized trials initiating glucagon-like peptide 1 receptor agonist therapy soon after diagnosis demonstrate lower insulin requirements and better-preserved stimulated C-peptide while on treatment, but these advantages often diminish after discontinuation. Combination approaches pairing immunomodulatory therapy with incretin-based metabolic support may improve durability.