Glucagon-like peptide-1 receptor agonists as a possible intervention to delay the onset of type 1 diabetes: A new horizon

Abstract

Type 1 diabetes (T1D) is a chronic autoimmune condition that destroys insulin-producing beta cells in the pancreas, leading to insulin deficiency and hyper-glycemia. The management of T1D primarily focuses on exogenous insulin replacement to control blood glucose levels. However, this approach does not address the underlying autoimmune process or prevent the progressive loss of beta cells. Recent research has explored the potential of glucagon-like peptide-1 receptor agonists (GLP-1RAs) as a novel intervention to modify the disease course and delay the onset of T1D. GLP-1RAs are medications initially developed for treating type 2 diabetes. They exert their effects by enhancing glucose-dependent insulin secretion, suppressing glucagon secretion, and slowing gastric emptying. Emerging evidence suggests that GLP-1RAs may also benefit the treatment of newly diagnosed patients with T1D. This article aims to highlight the potential of GLP-1RAs as an intervention to delay the onset of T1D, possibly through their potential immunomodulatory and anti-inflammatory effects and preservation of beta-cells. This article aims to explore the potential of shifting the paradigm of T1D management from reactive insulin replacement to proactive disease modification, which should open new avenues for preventing and treating T1D, improving the quality of life and long-term outcomes for individuals at risk of T1D.

Keywords: Type 1 diabetes; Semaglutide; Glucagon-like peptide-1 receptor agonists; Insulin therapy; Autoimmune response; Blood glucose monitoring; Β-cell preservation; Early screening; Teplizumab; Randomized controlled trials

Core Tip: New research suggests a novel approach to treating type 1 diabetes (T1D) by using glucagon-like peptide-1 receptor agonists, specifically semaglutide, to significantly improve blood glucose control and potentially slow the progression of the disease in newly diagnosed patients. This strategy, which leads to less insulin dependence and better metabolic markers, could change the way T1D is managed in a big way. At the same time, the study supports early T1D risk screening, especially in groups with high risk, so that early interventions can be made, evaluating the benefits against the possible emotional and financial effects. This dual approach shows that there are bright futures for improving the lives of patients with T1D.