Effects of Semaglutide on Weight and Insulin Requirements in Two Adolescents With Type 1 Diabetes

We present 2 case reports of the benefits of the subcutaneous once-weekly glucagon-like peptide 1 receptor agonist (GLP-1RA) therapy semaglutide in adolescents with type 1 diabetes (T1D) complicated by obesity. Two female individuals (17 and 12 years old) with T1D who have automated and continuous insulin delivery systems presented with marked weight gain, increasing insulin requirement, and suboptimal glycemic control. We added GLP-1RA to standard insulin pump therapy and revisited education related to healthy lifestyle. Both adolescents achieved notable improvements in glycemic control, weight, and insulin requirement after 12 months of treatment without any adverse events. These cases suggest that adjunctive GLP-1RA therapy may improve metabolic control and body weight management in adolescent T1D with obesity. Larger studies are needed to clarify optimal dosing and safety, including long-term effects on body composition and growth.