For years, the answer was no. GLP-1 receptor agonists were considered too risky for type 1 diabetes, and the caution traced back to trials that are now nearly a decade old. In 2026, the full picture finally arrived. In this solo episode, board-certified endocrinologist Dr. Arti Thangudu
walks through what the newest evidence actually shows, who stands to benefit, who should be cautious, and exactly how to bring this conversation to your own care team.
This episode explores
🧩 Why type 1 diabetes is not a childhood disease, and why the cardiovascular and kidney risks that drive mortality are largely preventable
🧩 Why the 2016 Adjunct trials raised real safety flags, and why those findings do not generalize to how we practice today
🧩 What the newer, better-designed research shows, including the Adjust-T1D trial and the latest real-world outcome data
🧩 The 2026 analyses linking GLP-1 use in type 1 to fewer cardiovascular events, less kidney disease, and lower hospitalization, without the feared spikes in DKA or low blood sugar
🧩 Who the right candidate is under the ADA 2026 Standards of Care, and who this is not appropriate for
🧩 Why this requires an endocrinologist, continuous glucose monitoring, and shared decision-making, never a five-minute prescription
This episode is for you if
You live with type 1 diabetes, love someone who does, or care for these patients, and you want a straight, evidence-based answer about GLP-1 medications instead of either blanket fear or wellness-influencer hype.
The bottom line
The evidence for GLP-1 receptor agonists in type 1 diabetes has crossed a meaningful threshold. These medications remain off-label in type 1 and require endocrinology expertise and close monitoring. But the blanket no is no longer supported by the data, and for the right person, the conversation is worth having now.
About the host
Dr. Arti Thangudu is a board-certified endocrinologist, founder of Complete Medicine and Hey Healthy, and host of Endocrine Matters. She focuses on women's metabolic health, type 1 diabetes in midlife, thyroid disease, and evidence-based, patient-first care, with a direct-care model built around the kind of time and attention specialist care actually requires.
Resources mentioned
- Adjunct 1 and Adjunct 2 trials (2016): liraglutide in type 1 diabetes
- Adjust-T1D trial (New England Journal of Medicine, 2025): semaglutide with automated insulin delivery
- Tirzepatide in adults with type 1 and BMI over 30
- Johns Hopkins real-world analysis (Nature Medicine, 2026): cardiovascular and kidney outcomes in type 1
- Cleveland Clinic propensity-matched analysis (2026): mortality and hospitalization outcomes
- ADA 2026 Standards of Care: GLP-1 use for obesity management in adults with type 1, BMI 30+, via shared decision-making
Learn more and connect
- Complete Medicine (The Woodlands, TX): https://www.sacomplete.com
- Newsletter and blog: https://www.sacomplete.com/complete-medicine-blog
- Instagram: https://www.instagram.com/drartithangudu
- Subscribe to Endocrine Matters wherever you listen, and share this episode with someone who needs it.
About Endocrine Matters
Endocrine Matters is a podcast about the science that actually matters for people living with diabetes and hormonal conditions, and the clinicians caring for them. Hosted by Dr. Arti Thangudu, it challenges conventional norms, calls out misinformation, and centers evidence-based, patient-first care. New episodes every Wednesday.
Chapters
00:00 Why this conversation matters now
01:00 The questions patients and clinicians keep asking
02:00 Type 1 is not a childhood disease: the real risk picture
03:00 Off-label status and the data gap
04:00 What I see clinically when patients start a GLP-1
04:30 The evidence arc begins: the 2016 Adjunct trials
06:00 Why those early fears don't generalize to how we practice now
07:00 Adjust-T1D and the newer trials
08:00 A lack of evidence is not evidence of no benefit
09:00 The 2026 real-world data: cardiovascular and kidney outcomes
10:30 Who is the right candidate, and who is not
12:00 CGM, titration, and sick-day planning
13:00 The bottom line and how to bring it to your doctor