The GLP-1 Revolution Reaches Type 1 Diabetes

A Johns Hopkins study finds GLP-1 receptor agonists cut cardiovascular and kidney risk in type 1 diabetes patients, drawing on 175,000 US health records

13 Apr 2026

GLP-1 drugs have already reshaped how medicine treats obesity and type 2 diabetes. Now a major US study suggests they may do the same for a population long left out of the conversation: people with type 1 diabetes.

The research, published in Nature Medicine and led by Johns Hopkins Bloomberg School of Public Health, drew on health records from roughly 175,000 type 1 diabetes patients across more than 60 US health systems. Using a method designed to simulate randomized trial conditions from real-world data, researchers found that patients on GLP-1 receptor agonists were 15% less likely to suffer a major cardiovascular event, 19% less likely to develop end-stage kidney disease, and faced an 18% lower risk of heart failure. Serious liver complications dropped by 28%.

Those numbers matter. Around 2 million Americans live with type 1 diabetes, and the condition carries a heavy lifetime burden of heart and kidney disease. Yet most GLP-1 clinical trials have focused on type 2 diabetes, leaving a critical evidence gap that this study begins to fill.

Perhaps equally striking are the safety findings. Clinicians have historically been cautious about prescribing GLP-1 therapies to type 1 patients, citing concerns about diabetic ketoacidosis and severe hypoglycemia. The study found rates of both were actually lower in the GLP-1 group. That alone could shift how treatment guidelines are written.

Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the study is observational, and the authors are careful to note that large-scale randomized controlled trials are still needed to confirm what the data shows. But the signals are consistent across multiple organ systems and span the full geographic breadth of the US. For patients and the clinicians managing their long-term risks, that is a meaningful shift in the evidence base.