Evidence mapPaperPMID 41429002Full record

Trial reportDiabetes care2026

Effect of Semaglutide on Insulin Dose Reduction in Adults With Type 1 Diabetes and Obesity Using Automated Insulin Delivery Systems: ADJUST-T1D Post Hoc Analysis.

Kagan E Karakus, Halis K Akturk, Davida Kruger, Andrew Ahmann, Anuj Bharvaga, Christine R Langel, Courtney A Ackeifi, Jonathan Rosen, Laura Pyle, Janet K Snell-Bergeon and 1 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Kagan E KarakusBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO.
Halis K AkturkBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO.ORCID 0000-0003-4518-5179
Davida KrugerDivision of Endocrinology, Diabetes, and Bone and Mineral Disease, Henry Ford Health, Detroit, MI.
Andrew AhmannDivision of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR.ORCID 0000-0002-4544-5404
Anuj BharvagaIowa Diabetes Research, West Des Moines, IA.
Christine R LangelIowa Diabetes Research, West Des Moines, IA.
Courtney A AckeifiBreakthrough T1D, New York, NY.
Jonathan RosenBreakthrough T1D, New York, NY.
Laura PyleDivision of Metabolism, Endocrinology and Nutrition, School of Medicine, University of Washington, Seattle, WA.ORCID 0000-0001-5577-8221
Janet K Snell-BergeonBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO.ORCID 0000-0002-9337-3740
Viral N ShahDivision of Endocrinology and Metabolism, Indiana University School of Medicine, Indianapolis, IN.ORCID 0000-0002-3827-7107

Funding

PILOT STUDY--SUBSTRATE METABOLISM IN EXTREMELY LOW BIRTH WEIGHT INFANTSP30DK048520 · UNIVERSITY OF COLORADO DENVER · 1995 to 2025
$7.7M
Breakthrough T1DNIDDK NIH HHS P30 DK048520
6 · The paper itself

Abstract

objectiveIn this post hoc analysis, we used the data from the Adjunct Semaglutide Treatment in Type 1 Diabetes (ADJUST-T1D) trial, a double-blind, multicenter, randomized, placebo-controlled trial of semaglutide 1 mg/week in adults with type 1 diabetes (T1D) and obesity, to evaluate the relationship between insulin dose reduction and weight loss. RESEARCH DESIGN AND

methodsChanges between semaglutide and placebo groups over 26 weeks in total daily insulin dose (TDD), basal and bolus insulin doses, carbohydrate intake, and user-initiated bolus counts were analyzed using linear mixed models. Mediation analysis was used to attribute direct effects of semaglutide versus weight loss on insulin dose reduction.

resultsFrom baseline to week 26, there was a significant 22.6% reduction in TDD (95% CI -28.3 to -17.0), which was driven by greater reductions in bolus insulin (-30.5%; 95% CI -39.5 to -21.5) than basal insulin (-15.6%; 95% CI -21.5 to -9.7). The basal-to-TDD ratio increased from 0.56 to 0.62 (P < 0.001) and insulin dose (in units/kg/day) decreased from 0.72 to 0.60 (P < 0.001) in the semaglutide group. At week 4, an 83% (-11.1 units/day) reduction in TDD was due to a direct drug effect, and 17% (-2.3 units/day) was attributed to weight loss, whereas at week 26, the difference was split evenly between direct effect (-11.4 units/day; 52%) and weight loss (-10.5 units/day; 48%). Daily carbohydrate intake decreased from 137 g (95% CI 107-167) at baseline to 107 g (95% CI 76-137) at 26 weeks.

conclusionsSemaglutide produced rapid, sustained, and primarily bolus-driven insulin dose reductions, with early effects being largely independent of weight loss in adults with T1D and obesity.

Indexed as

Diabetes Mellitus, Type 1Glucagon-Like PeptidesHypoglycemic AgentsInsulinObesityAdultDouble-Blind MethodFemaleHumansInsulin Infusion SystemsMaleMiddle AgedWeight LossGlucagon-Like PeptidesHypoglycemic AgentsInsulin

Identifiers

PMID41429002
PMCPMC13094866

What Socratic holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.