Author Block: SARAH LYONS, JOCHEN SEUFERT, SAKETH ROMPICHERLA, JULIA K. MADER, SUSAN THAPA, DAVID MAAHS, ANTONIA MÜLLER, JENISE C. WONG, CHRISTINA REINAUER, NESTORAS MATHIOUDAKIS, STEFANIE LANZINGER, Houston, TX, Freiburg, Germany, Boston, MA, Graz, Austria, Stanford, CA, Karlsburg, Germany, San Francisco, CA, Duesseldorf, Germany, Baltimore, MD, Ulm, Germany
Introduction and Objective: Since the latest report of the T1D Exchange (T1DX) and Prospective Diabetes Follow-up (DPV) registries on adjuvant pharmacotherapy use in type 1 diabetes (T1D) a decade ago, more medications for management of type 2 diabetes (T2D) have been approved that may also be beneficial for T1D. This study evaluated the use of T2D-approved agents as adjunctive therapy in T1D since 2018 in the T1DX and DPV registries.
Methods: Both registries separately analyzed adjuvant mediation use by class (metformin, GLP-1 RA, SGLT2i, DPP-4i), stratified by year (2018-2024) and by age range (<18 y, 18-<40 y, 40-<65 y, >65 y).
Results: In the T1DX, adjuvant medication use increased from 2.1% in 2018 to 5.6% in 2024, whereas in the DPV, utilization peaked at 2.2% in 2021. In both registries, the highest rates of any co-medication were observed in those >40 y (Figure 1a). While GLP-1 RA surpassed metformin in the T1DX in 2023, metformin remained most common in the DPV with SLGT-2i peaking in 2021 (Figure 1b).
Conclusion: Use of any adjuvant pharmacotherapy for T1D was infrequent in both registries, although the rate has been increasing recently in the T1DX, especially for GLP-1 RA. SLGT-2i peak in the DPV coincided with a temporary regulatory approval for T1D in Europe. Given the potential benefits of GLP-1 RA and SGLT2i for glycemic control, weight management, and cardiovascular health, more evidence is needed for a broader use of these medications in T1D.
