title: GLP-1 Agonists in Type 1 Diabetes Mellitus.
abstract: To review the use of GLP-1 agonists in patients with type 1 diabetes mellitus (T1DM).
  
  
  
  A search using the MEDLINE database, EMBASE, and Cochrane Database was performed through March 2016 using the search terms glucagon-like peptide 1 (GLP-1) agonists, incretin, liraglutide, exenatide, albiglutide, dulaglutide, type 1 diabetes mellitus
  
  
  
  All English-language trials that examined glycemic end points using GLP-1 agonists in humans with T1DM were included.
  
  
  
  A total of 9 clinical trials examining the use of GLP-1 agonists in T1DM were identified. On average, hemoglobin A1C (A1C) was lower than baseline, with a maximal lowering of 0.6%. This effect was not significant when tested against a control group, with a relative decrease in A1C of 0.1% to 0.2%. In all trials examined, reported hypoglycemia was low, demonstrating no difference when compared with insulin monotherapy. Weight loss was seen in all trials, with a maximum weight loss of 6.4 kg over 24 weeks. Gastrointestinal adverse effects are potentially limiting, with a significant number of patients in trials reporting nausea.
  
  
  
  The use of GLP-1 agonists should be considered in T1DM patients who are overweight or obese and not at glycemic goals despite aggressive insulin therapy; however, tolerability of these agents is a potential concern. Liraglutide has the strongest evidence for use and would be the agent of choice for use in overweight or obese adult patients with uncontrolled T1DM.
authors.affiliation: Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA Indiana University Health, Indianapolis, IN, USA kjanzen@butler.edu.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Janzen
authors.affiliation: Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA Indiana University Health, Indianapolis, IN, USA.
authors.forename: Taylor D
authors.initials: TD
authors.lastname: Steuber
authors.affiliation: Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA Indiana University Health, Indianapolis, IN, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Nisly
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage / Q000009:adverse effects / Q000819:agonists* / Q000031:analogs & derivatives / Q000627:therapeutic use*; D004763:Glucagon-Like Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007141:Immunoglobulin Fc Fragments / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D054795:Incretins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000069450:Liraglutide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014688:Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1; D004763:Glucagon-Like Peptides; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007141:Immunoglobulin Fc Fragments; D054795:Incretins; D000069450:Liraglutide; D010455:Peptides; D011993:Recombinant Fusion Proteins; D014688:Venoms; C534611:rGLP-1 protein; C555680:dulaglutide
keywords: GLP-1 agonists; albiglutide; diabetes; dulaglutide; exenatide; liraglutide; type 1 diabetes