# GLP-1 and Type 1 Diabetes: Can You Use It? (2026 Evidence) Source: https://www.dietglp.com/blog/glp-1-type-1-diabetes/ Published: 2026-10-29 Keywords: glp-1 type 1 diabetes, glp 1 and type 1 diabetes, can you take glp 1 with type 1 diabetes, use of glp 1 in type 1 diabetes, glp 1 approved for type 1 diabetes, can glp 1 agonists be used in type 1 diabetes, glp-1 type 1 diabetes study, glp 1 type 1 diabetes clinical trials, glp 1 type 1 diabetes weight loss, what glp 1 can type 1 diabetes patients take, does glp 1 treat type 1 diabetes, glp 1 type 1 diabetes fda, glp 1 meds for type 1 diabetes **TL;DR:** No GLP-1 drug is FDA-approved for type 1 diabetes as of October 2026. Ozempic and Mounjaro are approved for type 2 only, and the weight-loss drugs Wegovy, Zepbound and Foundayo are not approved for any type of diabetes treatment. Still, the ADA 2026 Standards of Care say adults with type 1 diabetes and obesity can consider a GLP-1 drug added to insulin, and a 2025 trial found semaglutide cut weight by about 8.8 kg versus placebo. The main risks are low blood sugar and ketoacidosis if insulin is cut too far, so this is a decision for your diabetes team. If you do start one, [Sharpy](https://apps.apple.com/us/app/glp-diet-app-sharpy/id6762084138) helps you keep protein and strength up so the weight you lose is mostly fat. Can you use a GLP-1 drug if you have type 1 diabetes? The short answer: no GLP-1 is FDA-approved for type 1 diabetes, but doctors can and sometimes do prescribe one off-label, mostly for adults with type 1 who also have obesity. The American Diabetes Association (ADA) now says that is a reasonable option to consider. Insulin stays. The GLP-1 is an add-on, and it needs closer blood sugar watching, not less. This guide explains where each drug stands, what the trials found, the real risks, and what to ask your diabetes team. ## Is any GLP-1 approved for type 1 diabetes? No. Here is how the main labels read in October 2026, checked on the FDA label database. | Drug | What it is approved for | What the label says about type 1 | |---|---|---| | Ozempic (semaglutide shot) | Type 2 diabetes, heart and kidney risk in type 2 | Approved for type 2 only. Older labels said it "is not indicated for use in patients with type 1 diabetes mellitus." | | Mounjaro (tirzepatide) | Type 2 diabetes in adults and children 10+ | Approved for type 2 only | | Victoza (liraglutide) | Type 2 diabetes | "Should not be used in patients with type 1 diabetes mellitus" | | Wegovy (semaglutide) | Weight loss, heart risk in obesity | Use in type 1 diabetes "has not been evaluated" | | Zepbound (tirzepatide) | Weight loss, sleep apnea with obesity | No type 1 approval; warns of more low blood sugar with insulin | | Foundayo (orforglipron) | Weight loss | Weight-loss approval only | The Ozempic and Zepbound labels both warn that using them with insulin can raise the risk of low blood sugar, including severe lows, and that the insulin dose may need to come down. See our [GLP-1 medication comparison](/blog/glp1-medication-comparison/) for how the drugs differ in general. ## Why GLP-1 drugs were not made for type 1 diabetes In type 2 diabetes, the pancreas still makes insulin but the body uses it poorly. GLP-1 drugs help by making the pancreas release more insulin when blood sugar is high, lowering glucagon, slowing the stomach and cutting appetite. Our guide to [GLP-1 and insulin resistance](/blog/glp1-and-insulin-resistance/) covers that side. In type 1 diabetes, the immune system has destroyed most of the cells that make insulin. So the main GLP-1 effect, more insulin, has little to work with. The other effects still work: less glucagon, slower digestion, less hunger and weight loss. That is why researchers keep testing these drugs in type 1, mostly for weight and to smooth out blood sugar after meals. ## What the type 1 diabetes trials show | Trial | Drug | Who was in it | Main results | |---|---|---|---| | ADJUNCT ONE (Diabetes Care, 2016) | Liraglutide up to 1.8 mg | 1,398 adults with type 1 | A1C fell about 0.5 points vs 0.3 on placebo; weight dropped about 3 to 4 kg; more symptomatic lows and more high sugar with ketosis | | ADJUST-T1D (NEJM Evidence, 2025) | Semaglutide up to 1 mg weekly | 72 adults with type 1, BMI 30+, all on automated insulin delivery | 36% hit the combined goal vs 0% on placebo; weight down 8.8 kg vs placebo; A1C down 0.3 points; time in range up 8.8 points; no DKA | | SURPASS-T1D-1 | Tirzepatide | 905 adults with type 1 and obesity or overweight | Ongoing, 40-week A1C goal, primary completion estimated Nov 2026 | | SURPASS-T1D-2 | Tirzepatide | 465 adults with type 1 and obesity or overweight | Ongoing, longer-term safety and A1C | A few things stand out. **Liraglutide did not earn a type 1 label.** Novo Nordisk said in 2015 it would not seek a type 1 approval for Victoza. The A1C drop was small and the extra lows and ketosis cancelled out much of the benefit. **Semaglutide with modern tech looked better.** The ADJUST-T1D "combined goal" meant three things at once: more than 70% of the day in range, less than 4% of the day low, and at least 5% weight loss. About a third of people on semaglutide got there, compared with nobody on placebo. Each group had two severe low blood sugar events. A follow-up analysis in Diabetes Care found total daily insulin went down by about 22.6%, mostly mealtime insulin. Still, this was 72 people over 26 weeks. **Tirzepatide results are coming.** Lilly's two Phase 3 type 1 trials are the first large tests of a GIP/GLP-1 drug in this group. If they work and are safe, they could lead to the first approval in type 1. Nothing is confirmed yet. For other ongoing studies, see our [GLP-1 research summary](/blog/glp1-research-summary/). ## Can you use GLP-1 with type 1 diabetes? What the ADA says now The ADA's Standards of Care in Diabetes for 2026, published in Diabetes Care in January 2026, added GLP-1 drugs and metabolic surgery as add-on options alongside insulin for people with type 1 diabetes and obesity. That is a big shift in tone, but it is not an FDA approval. In practice it means: - It is off-label, so insurance may not cover it. Many plans only pay for these drugs with a type 2 diagnosis or an approved weight-loss indication. - It is mostly for adults with type 1 who also have obesity, not for type 1 alone. - Your endocrinologist or diabetes team should be the one to start it and adjust insulin with you. ## The risks: lows, DKA and "too little insulin" This is the part that matters most if you live with type 1. **Low blood sugar.** A GLP-1 drug cuts how much you eat. If your mealtime and basal insulin stay the same, lows become more likely. The Ozempic and Zepbound labels both say so. **Diabetic ketoacidosis (DKA).** The opposite problem. If insulin is cut too far, or skipped on days when nausea means you barely eat, your body can start burning fat for fuel fast and build up ketones. In ADJUNCT ONE, high blood sugar with ketosis was more common on liraglutide. ADJUST-T1D, where everyone used an automated insulin system, reported no DKA. Your team may ask you to check ketones on sick or low-food days. **Stomach side effects.** Nausea and vomiting are common early on, the same as in type 2. Vomiting plus less food plus insulin is a tricky mix. Questions worth bringing to your diabetes team: 1. How should my basal and mealtime insulin change, and how fast? 2. When should I check ketones, and what number means call you? 3. What do I do on a day I cannot keep food down? 4. Does my CGM or pump need new alerts or settings? 5. Will my insurance cover this off-label, and what if it does not? Do not change your insulin doses on your own. Never stop insulin. ## Protecting muscle if you lose weight with type 1 GLP-1 drugs shrink appetite, and when people eat much less, part of the weight lost can be muscle. That matters in type 1 diabetes too, because muscle is where a lot of glucose goes after a meal. Two habits help most: enough protein and regular strength work. Our guide on [how much protein you need on a GLP-1](/blog/protein-target-on-glp1/) gives the numbers, and the [beginner strength program](/blog/beginner-strength-program-glp1/) needs no gym. [Sharpy](https://apps.apple.com/us/app/glp-diet-app-sharpy/id6762084138) turns both into one daily protein target and one 20-minute workout, and shows progress as a Shape Score instead of only the scale. With type 1, exercise can push blood sugar down, so plan workouts and snacks with your diabetes team and keep your CGM alerts on. ## The bottom line - No GLP-1 drug is FDA-approved for type 1 diabetes in 2026. - The ADA now lists GLP-1 drugs as an add-on option for adults with type 1 diabetes and obesity. - Trials show modest A1C gains, lower insulin needs and real weight loss, with more lows and possible ketosis to manage. - Tirzepatide type 1 trial results may arrive in 2027. If you and your team decide to try one, protect your muscle while the weight comes off. [Sharpy](https://apps.apple.com/us/app/glp-diet-app-sharpy/id6762084138) is free to try on the App Store and keeps the daily plan simple. Pregnant, under 18, or a history of eating disorders? Talk with your doctor first, as these drugs are not a fit for everyone. ## Sources - [Ozempic, Mounjaro, Wegovy, Zepbound, Foundayo and Victoza prescribing information (openFDA / DailyMed, checked Oct 29, 2026)](https://dailymed.nlm.nih.gov/dailymed/) - [Shah VN et al., Semaglutide in Adults with Type 1 Diabetes and Obesity (ADJUST-T1D), NEJM Evidence 2025](https://www.themednet.org/publications/semaglutide-in-adults-with-type-1-diabetes-and-obesity) - [ADA Meeting News: Add-on semaglutide in type 1 diabetes and obesity](https://www.adameetingnews.org/add-on-drug-therapy-improves-glycemic-outcomes-and-weight-loss-in-adults-living-with-type-1-diabetes-and-obesity/) - [ACP Diabetes: ADJUNCT ONE, liraglutide added to insulin in type 1 diabetes (Mathieu et al., Diabetes Care 2016)](https://diabetes.acponline.org/archives/2017/01/13/6.htm) - [Healio: Victoza will not be expanded for type 1 diabetes use (Aug 2015)](https://cm.healio.com/news/endocrinology/20150830/victoza-will-not-be-expanded-for-type-1-diabetes-use) - [ClinicalTrials.gov: SURPASS-T1D-1 (NCT06914895)](https://clinicaltrials.gov/study/NCT06914895) - [ClinicalTrials.gov: SURPASS-T1D-2 (NCT06962280)](https://clinicaltrials.gov/study/NCT06962280) - [Patient Care: ADA publishes 2026 Standards of Care (Dec 9, 2025)](https://www.patientcareonline.com/view/ada-publishes-2026-standards-of-care-with-updates-to-sections-on-technology-obesity-cardiometabolic-disease-management) ## Frequently asked questions **Q: Can you take a GLP-1 with type 1 diabetes?** A: Some people do, but only off-label and under close medical care. No GLP-1 drug is FDA-approved to treat type 1 diabetes. The American Diabetes Association's 2026 Standards of Care say a GLP-1 drug can be considered as an add-on to insulin for adults with type 1 diabetes and obesity. Insulin is always still needed. **Q: Is any GLP-1 approved for type 1 diabetes?** A: No. As of October 29, 2026, the FDA has not approved any GLP-1 or GIP/GLP-1 drug for type 1 diabetes. Older Ozempic labels said directly that it is not indicated for type 1, and Victoza's label says it should not be used in type 1 diabetes. **Q: Does a GLP-1 treat type 1 diabetes?** A: No. Type 1 diabetes means the body makes little or no insulin, and a GLP-1 drug cannot replace insulin. In trials it lowered A1C a little (about 0.3 to 0.5 points), reduced insulin doses and helped with weight, but everyone still needed insulin. **Q: How much weight can you lose on a GLP-1 with type 1 diabetes?** A: In the ADJUST-T1D trial, adults with type 1 diabetes and obesity on semaglutide (up to 1 mg weekly) lost about 8.8 kg (19 lb) more than placebo over 26 weeks. That was a small trial of 72 people, so results may differ in practice. **Q: What are the risks of GLP-1 drugs in type 1 diabetes?** A: The two big ones are low blood sugar, because GLP-1 drugs plus insulin raise the hypoglycemia risk, and diabetic ketoacidosis (DKA) if insulin is reduced too much while eating very little. Nausea and vomiting are common at the start and can make both risks worse. **Q: Is tirzepatide being tested in type 1 diabetes?** A: Yes. Lilly is running two Phase 3 trials, SURPASS-T1D-1 (905 people) and SURPASS-T1D-2 (465 people), in adults with type 1 diabetes and obesity or overweight. ClinicalTrials.gov lists both as active and not recruiting, with primary completion estimated for November 2026.