Liraglutide as an adjunct in T1D
Novo Nordisk / generic manufacturers
What it is
Daily GLP-1 therapy studied as an adjunct to insulin in large T1D trials. Modest HbA1c and weight benefits were accompanied by more symptomatic hypoglycemia and hyperglycemia with ketosis; T1D use is off-label.
Editorial review: . What was checked and what remains uncertain.
Source dates appear in the references where available; this record has no dated citation metadata.
Trial status, labels and access can change between reviews.
Evidence behind this assessment
Key evidence notes. Study results, product eligibility and access answer different questions.
- Who was studied?
- Study populations and analysis groups vary. Product age limits alone do not describe who was studied.
- Benefit or performance
- Glycemic benefit: Placebo-adjusted HbA1c benefit 0.20 points at 1.8 mg after 52 weeks.[1]
- Important harms and treatment burden
- Safety: Higher symptomatic hypoglycemia and hyperglycemia with ketosis.[1]
- Approval and country access
- US medicine labeling verified; T1D adjunct use is off-label. Other national availability and funding were not independently verified in this pass.Approval, trial recruitment, local supply and funding are separate. Check the cited label or access source.
- Follow-up and remaining uncertainty
- Read the record-specific review limits for gaps in evidence, source access or availability checks.
Editorial score: calculation and evidence
A weighted editorial judgment on a 0–100 scale, not a probability of success or a measured treatment effect. Higher criterion scores mean more favorable assessments.
Default calculation: 40 × 25 + 30 × 25 + 65 × 15 + 80 × 20 + 35 × 15 = 4850; divide by total weight 100. Unrounded weighted result: 48.5.
These are scored as add-ons to insulin in Type 1 diabetes, never on their Type 2 diabetes evidence — a drug with a large Type 2 trial base but only small Type 1 studies scores low on maturity. Safety carries heavy weight here because the best-known adjunct risk, diabetic ketoacidosis at normal glucose levels, is potentially fatal and specific to Type 1. Most of this class is used off-label; that is reflected in access, not hidden.
Editor’s take
Scores are editorial judgments about the evidence and practical features, not measured comparative performance or a probability of success.
The full picture
ADJUNCT ONE randomized 1,398 adults for 52 weeks. At 1.8 mg, the placebo-adjusted HbA1c difference was −0.20 percentage points and weight difference −4.9 kg. Symptomatic hypoglycemia increased (event-rate ratio 1.31), as did hyperglycemia with ketosis (ratio 2.22). These are event-rate ratios, not proportions of participants affected or DKA counts.1
The trial authors concluded that these safety findings limited clinical use. Results from semaglutide or tirzepatide should not be substituted for liraglutide’s own evidence. Victoza’s diabetes indication is for type 2; this record concerns off-label adjunct use in T1D and does not replace insulin or individual review of the medicine’s warnings.2
Victoza carries a boxed thyroid C-cell tumor warning and is contraindicated with a personal or family history of medullary thyroid carcinoma or MEN2. Pancreatitis, severe gastrointestinal reactions and hypoglycemia with insulin require the label’s precautions; reduced food intake must not lead to unsafe insulin omission.2
References
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ADJUNCT ONE randomized trial. https://pubmed.ncbi.nlm.nih.gov/27506222/ ↩
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Victoza US prescribing information. https://www.novo-pi.com/victoza.pdf ↩ ↩2
Sources
- [1]ADJUNCT ONE randomized trial · peer-reviewed
- [2]Victoza US prescribing information · regulatory