Background:Patients with type 1 diabetes mellitus (T1DM) may have suboptimal glucose
control and are interested in the use of adjuvant therapies.Objectives:To determine, from the patients’ perspective, the reasons for initiation of
glucagon-like peptide 1 receptor agonist (GLP-1RA) and/or sodium glucose
cotransporter 2 inhibitor (SGLT2i) in treating T1DM; perceived benefits/side
effects, reasons for discontinuation, and willingness to reinitiate
therapy.Design:Retrospective chart review with structured telephone interviews.Methods:We identified patients with T1DM treated with a GLP-1RA and/or SGLT2i for
>3 months at University of Texas Southwestern Medical Center (Dallas, TX,
USA) and Poznan University (Poznan, Poland). We conducted structured
telephone interviews regarding their experiences.Results:We interviewed 68 participants treated with GLP-1RA and 82 with SGLT2i.
Treatment was initiated for improving glycemic control (as reported by 61.8%versus81.7% of GLP-1RA and SGLT2i users,
respectively), weight loss/appetite suppression (51.4%versus23.2%) and to reduce insulin requirement (13.2%versus11%). Most participants (86.8% of GLP-1RA and
89.0% of SGLT2i users) reported ⩾1 benefit attributed to therapy. Reported
benefits were improved glycemic control (reported by 58.8%versus82.9% of GLP-1RA and SGLT2i users,
respectively), weight loss/appetite suppression (63.2%versus30.5%), and reduced insulin requirement (27.9%versus34.1%). More GLP-1RA users reported side effectsversusSGLT2i users (63.2%versus36.6%); 22.6% discontinued GLP-1RA due to side effectsversus11.0% SGLT2i users. Diabetic ketoacidosis (DKA)
was reported by 4.9% of SGLT2i users, but none in GLP-1RA users. Of those
who discontinued medication, 60.7% of GLP-1RAversus56.0%
of SGLT2i prior users were willing to reinitiate treatment.Conclusions:Patients with T1DM report initiating adjuvant treatment with GLP-1RA and/or
SGLT2i to improve glycemic control and lose weight; most patients reported
perceived benefits from these therapies. Side effects (including DKA) are
reported more commonly in real life than in clinical trials. Given patient
interest in these medications, further studies should evaluate the long-term
risk–benefits ratio in larger cohorts.