{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T19:21:29Z","timestamp":1791055289955,"version":"4.1.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019091","name":"Key Research and Development Program of Hunan Province of China","doi-asserted-by":"publisher","award":["2018SK2065"],"award-info":[{"award-number":["2018SK2065"]}],"id":[{"id":"10.13039\/501100019091","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> To assess the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) used as an adjunct to insulin therapy in adults with type 1 diabetes.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A search of electronic databases (Medline, Embase, and the Cochrane Central Register of Controlled Trials) from 1 January 1950 to 23 May 2021 was conducted to find randomized controlled trials. The primary outcome was the change in HbA1c. Eight efficacy and six safety secondary endpoints were evaluated <jats:italic>via<\/jats:italic> meta-analysis. Weighted mean difference (WMD) and odds ratio (OR), alongside 95% confidence interval (CI), were calculated using the random effects model.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Among 1,379 candidate studies, 11 trials comprising 2,856 participants satisfied the inclusion criteria. Overall, GLP-1 RA adjunctive therapy reduced HbA1c by \u22120.21% (95% CI, \u22120.33 to \u22120.10), weight by \u22124.04\u00a0kg (\u22124.8 to \u22123.27), systolic pressure by \u22122.57\u00a0mmHg (\u22124.11 to \u22121.03), and diastolic blood pressure by \u22121.02\u00a0mmHg (\u22121.99 to \u22120.06). In addition, there was a decrease in prandial insulin dose (WMD, \u22124.23 IU; 95% CI, \u22125.26 to \u22123.20), basal insulin dose (\u22122.40 IU; \u22123.93 to \u22120.87), and total insulin dose (\u22125.73 IU; \u221210.61 to \u22120.86). Moreover, GLP-1 RAs did not increase the incidence of severe hypoglycemia, diabetic ketoacidosis, or severe adverse events. However, GLP-1 RAs increased the incidence of gastrointestinal adverse events (OR, 2.96; 95% CI, 2.33\u20133.77).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Our meta-analysis of randomized clinical trials suggests moderate beneficial effects of GLP-1 RAs on the metabolic profile in patients with type 1 diabetes, without an increased risk of serious adverse events.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO<\/jats:ext-link>; Identifier: CRD 42020199840.<\/jats:p>","DOI":"10.3389\/fphar.2023.975880","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T10:07:42Z","timestamp":1704449262000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":44,"title":["Glucagon-like peptide-1 receptor agonists as add-on therapy to insulin for type 1 diabetes mellitus"],"prefix":"10.3389","volume":"14","author":[{"given":"Xinrui","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiongfeng","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochuan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songjia","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghai","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingxing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.2337\/dc16-0690","article-title":"Efficacy and safety of liraglutide added to capped insulin treatment in subjects with type 1 diabetes: The ADJUNCT TWO randomized trial","volume":"39","author":"Ahr\u00e9n","year":"2016","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S7","DOI":"10.2337\/dc21-S001","article-title":"1. 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