SAT-621 Real World Utilization of GLP-1 Agonists in Adolescents and Young Adults With Type 1 Diabetes (T1D) and Obesity

Abstract Disclosure: M. Munoz: None. T. Maxwell: None. S.M. Willi: None. M.R. Rickels: None. L. Katz: None. Background: Individuals with type 1 diabetes (T1D) face ongoing challenges to achieve recommended targets for glycemic control, further complicated by obesity and insulin resistance. Approximately 20% of individuals with T1D are obese. Glucagon-like peptide-1 receptor agonists (GLP1-RA), approved for type 2 diabetes and obesity, have emerged as potential adjunct therapies in T1D. Recent studies in adults with T1D and obesity demonstrate a reduction in HbA1c, weight, and total insulin dose (TDD). Hypothesis: We hypothesize that GLP1-RA are safe and effective in reducing weight and improving glycemic control in adolescents and young adults with T1D and obesity without increasing hypoglycemia. Methods: This retrospective cohort study was conducted at a large, urban academic children’s and adult hospitals. Patients were identified by an electronic health record search for GLP1-RA prescriptions between 2014 and 2024. Inclusion criteria were age 10-35 years with a diagnosis of T1D requiring insulin, obesity, and GLP1-RA treatment for 3 months.Primary outcomes included changes in BMI, and glucose time in range (TIR, 70-180 mg/dL) and time below range (TBR, <70 mg/dL) on continuous glucose monitor (CGM). Secondary outcomes included TDD, HbA1c, and weight change. Outcomes were analyzed by paired t-test two sample for Means. Results: We identified 24 individuals (14 F, 10 M; mean age 19.4 yrs and diabetes duration 10.7 yrs). Charts were reviewed on the date of GLP1-RA initiation and two subsequent follow up visits: 3-5 months and 6-10 months after GLP1-RA initiation.Pre-treatment values: HbA1c 8.0% (n=22), weight 105.3 kg (n=23), BMI 37.1 (n=24), TDD 1.04 units/kg (n=18), TIR 55% (n=20), TBR 3.2% (n=20). At 1st follow-up: HbA1c 7.5% (n=16, p=0.05*), weight -4.4% (n=22, p=0.04*), BMI -4.8% (n=21, p=0.04*), TDD 0.95 units/kg (n=18, p=0.06), TIR 62.9% (n=19, p=0.06), TBR 2.1% (n=19, p=0.56). At 2nd follow-up: HbA1c 7.4% (n=16, p=0.21), weight -5.6% (n=16, p=0.03*), BMI -6.1% (n=16, p=0.01*), TDD 1.0 units/kg (n=12, p=0.07), TIR 63.3% (n=15, p=0.06), TBR 2.8% (n=15, p=0.35). Values of statistical significance (p<0.05) marked by *.Side effects were predominantly gastrointestinal that were self-reported and without hospitalization. No episodes of severe hypoglycemia requiring assistance were documented and only 1 episode of DKA was observed in a patient with a history of insulin non-compliance. Conclusion: In this case series, patients experienced improvements in BMI and initial improvement in HbA1C. This study is limited due to size, documentation inconsistencies, and incomplete follow up from patients. Further studies should focus on larger populations powered to detect statistical differences and long-term effects. GLP1-RA offers a promising and safe adjunctive therapy for patients with T1D and obesity due to its effects on weight, BMI, and HbA1c. Presentation: Saturday, July 12, 2025