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Randomized controlled trials (RCTs) with a duration of\u2009\u2265\u200912\u00a0weeks were deemed eligible for the primary outcome (change in HbA\n                      <jats:sub>1c<\/jats:sub>\n                      ) and change in body weight. RCTs with a duration of\u2009\u2265\u20094\u00a0weeks were deemed eligible for the incidence of severe hypoglycemia, time-in-range (TIR), total insulin dose (TID), change in C-peptide, and glucagon levels. We calculated mean differences (MDs) for continuous outcomes and odds ratios (ORs) for severe hypoglycemia, alongside 95% CIs using an inverse-variance weighted random-effects model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 25 RCTs were eligible. Compared with placebo, use of GLP-1RA was associated with a reduction in HbA\n                      <jats:sub>1c<\/jats:sub>\n                      (MD -0.23%, 95% CI -0.30, -0.17), body weight (MD -3.93\u00a0kg, 95% CI -4.29, -3.56), and TID (MD -5.74 U\/day, 95% CI -7.30, -4.19). Addition of GLP-1RAs did not significantly affect time-in-range. Based on data from 13 studies, the odds for severe hypoglycemia were similar between patients receiving GLP1-RA and placebo. Qualitative assessment of individual trials showed that addition of GLP-1RA does not prevent progressive C-peptide loss and that patients receiving a GLP-1RAs do not have inadequate glucagon secretion in response to hypoglycemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The addition of GLP-1RA on top of insulin therapy in people with T1D results in a modest reduction in HbA\n                      <jats:sub>1c<\/jats:sub>\n                      , body weight, and TID without increasing the risk for severe hypoglycemia.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s42000-025-00704-9","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T17:02:41Z","timestamp":1754326961000},"page":"1141-1151","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Glucagon-like peptide-1 receptor agonists as add-on therapy to insulin for type 1 diabetes mellitus: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"24","author":[{"given":"Eleni","family":"Rebelos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna A.","family":"Anastasiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Tentolouris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Karagiannis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Tsapas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ele","family":"Ferrannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aris","family":"Liakos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"704_CR1","doi-asserted-by":"publisher","first-page":"2449","DOI":"10.1016\/S0140-6736(18)31320-5","volume":"391","author":"LA DiMeglio","year":"2018","unstructured":"DiMeglio LA, Evans-Molina C, Oram RA (2018) Type 1 diabetes. 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