GLP-1 therapies are being used off-label in type 1 diabetes (T1D), and new consensus guidelines are here to help clinicians do it safely. The guidance covers dosing, insulin adjustment, monitoring, and safety protocols — filling a critical gap left by the lack of regulatory approval. Meanwhile, a promising phase 2 trial of acmopatide showed real benefits in T1D patients, only for manufacturer Roche to shelve the drug for business reasons.
Incretin-based therapies like semaglutide and tirzepatide aren't approved for type 1 diabetes (T1D), but clinicians are prescribing them off-label anyway — and a new consensus report published in Diabetes Technology & Therapeutics aims to make that safer. Backed by major diabetes organizations, the guidelines offer practical recommendations for clinicians navigating this uncharted territory.
Adding to the urgency: a phase 2 trial of acmopatide (CT-868), a novel GLP-1/GIP receptor agonist, showed meaningful reductions in A1c, weight, and insulin use in T1D patients — only for manufacturer Roche to announce it won't move the drug forward, citing business reasons. Clinicians at the ADA 2026 Scientific Sessions expressed deep disappointment at the decision.
Key Takeaways:
Why it matters: With insurance coverage inconsistent and no approved T1D indication, many patients are left without access or adequate safety guidance. These guidelines help bridge that gap until formal approvals arrive.
