Beyond Insulin: Exploring Combination Therapies for Type 1 Diabetes

Despite advances in insulin formulations and delivery devices like pumps and continuous glucose monitors, many people with Type 1 diabetes find it difficult to consistently achieve their target blood sugar levels. This ongoing challenge has motivated researchers and clinicians to explore additional treatment options that work alongside insulin therapy.

Adjunct therapy means adding a second medication to a primary treatment—in this case, adding glucose-lowering agents to insulin. The goal is to help lower hemoglobin A1c (a measure of average blood sugar over three months) and improve other health outcomes, such as weight management.

Researchers are examining two types of drugs as potential adjunctive therapies for Type 1 diabetes:

GLP-1 receptor agonists (also called incretin-based therapies) help the body regulate blood sugar and may also support weight management. SGLT-1 and SGLT-2 inhibitors work by helping the kidneys remove excess glucose through urine.

Neither drug class is currently FDA-approved for use in Type 1 diabetes. However, some doctors prescribe them off-label—meaning outside their approved indication—when they believe a patient may benefit.

The idea of combining GLP-1 receptor agonists with SGLT inhibitors is based on the theory that their different mechanisms of action may work synergistically. Used together alongside insulin, this combination could potentially help people achieve better blood sugar control and weight outcomes than insulin alone or insulin with a single adjunct medication.

This remains an active area of research, and clinicians are exploring when, how, and for whom such combinations might be most beneficial.

If you or a loved one has Type 1 diabetes and is struggling to reach blood sugar targets despite optimized insulin therapy, these emerging approaches may be worth discussing with your healthcare team. However, any treatment decisions should be made in consultation with your doctor, who can weigh the potential benefits and risks for your individual situation.

The research into adjunct therapies reflects ongoing efforts to improve outcomes for people with Type 1 diabetes. As evidence accumulates, we may see more clarity about the role these medications could play in diabetes management.

Source: Endocrinology and metabolism clinics of North America. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.