Weight-loss medications such as Ozempic, Wegovy, and Mounjaro, members of a category of medications known as GLP-1 receptor agonists, have gained popularity over the years due to their ability to regulate blood sugar levels and assist patients in losing weight.
Numerous individuals with type 2 diabetes and obesity have been prescribed the drugs, but increasingly, individuals with type 1 diabetes are also making greater use of them. Doctors, though, are questioning the potential risks these drugs can pose to patients who already have a chronic disease.
According to a March 2025 study, there has been an incredible increase in the use of GLP-1s in people with type 1 diabetes. With 38% of people with type 1 diabetes being obese, the obesity rate in people with the disease has increased, and the majority are looking for GLP-1s to help lose weight. Approximately 17% of those who were obese and 27% of those who were obese with type 1 diabetes were prescribed these medications from 2020 to 2023.
The FDA has licensed the drugs to be used for the treatment of type 2 diabetes and obesity but not to be used for the treatment of type 1 diabetes, which occurs in about 10% of all diabetic patients and usually first appears in childhood.
Type 1 diabetes is caused by the body’s immune system mistakenly attacking the insulin-producing pancreatic cells. Insulin is thus vital for the survival of individuals with type 1 diabetes, and in the absence of it, high blood sugar can lead to deadly effects such as kidney failure, nerve damage, and heart disease.
For a long time, patients with type 1 diabetes were thought to be slim or of ordinary weight. GLP-1 use, however, has increased because of an increase in obesity, especially among Black and Hispanic kids with type 1 diabetes. These drugs are well known for their ability to reduce hunger, lower blood sugar, and enhance glycemic management in general.
Despite the potential advantages, using these medications carries significant dangers for those who have type 1 diabetes. Hypoglycemia, or hazardous dips in blood sugar, is a disease that doctors are most worried about. Combining GLP-1s with insulin therapy may result in hypoglycemia, which is a condition where blood sugar levels drop too low because GLP-1s promote the synthesis of insulin.
However, lowering insulin dosages in response to these drugs may cause hyperglycemia, which is characterized by dangerously elevated blood sugar levels that may also have more damaging effects.
One of the primary dangers is developing a life-threatening condition known as diabetic ketoacidosis (DKA). This is when the body begins to break down fat rather than glucose for fuel, resulting in extremely high levels of ketones that, if not treated, can cause coma or death.
Researchers are urging studies on the long-term safety of GLP-1s for type 1 diabetes patients. Stanford Medicine clinical endocrinologist Dr. Marina Basina stresses that further studies are necessary to know what happens when this class of medicines is used alongside insulin therapy for this particular subgroup of patients.
Meanwhile, physicians recommend that adults with type 1 diabetes weighing the use of GLP-1 medicines carefully monitor their own blood sugar and consider the benefits and risks thoroughly.
With more GLP-1 drugs on the market, the word from physicians is out. Although such medication can bring some short-term gains, its long-term implications for individuals who have type 1 diabetes are not yet clear.
