Shenker Michal Nevo, Shalitin Shlomit
Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Horm Res Paediatr. 2025;98(4):405-424. doi: 10.1159/000541228. Epub 2024 Sep 2.
Despite all the technological advances in treatment of patients with type 1 diabetes (T1D), glucose control remains suboptimal in most patients. In addition, a relatively high percentage of patients with T1D, including children, have obesity. Therefore, new interventions are required that focus their effects on weight loss, in order to help with associated insulin resistance and improve glycemic control.
GLP-1 receptor agonists (GLP-1 RAs) have proven to be effective and safe in adults with T1D, showing improvement in glycemic control, body weight and cardiorenal protection. GLP-1 RAs are also approved for children with obesity (above the age of 12 years) or type 2 diabetes (above the age of 10 years). However, currently these medications are not approved for use in children with T1D. Only a few published studies have evaluated their efficacy and safety for this indication.
This review presents the rationale and experience of add-on GLP-1 RA therapy to pediatric and adolescent patients with T1D, otherwise treated, from RCTs and real-world data. Results of studies of GLP-1 RA in children with T1D are still pending, while large multicenter randomized controlled trials (RCTs) in this population are lacking.
尽管在1型糖尿病（T1D）患者的治疗方面取得了所有技术进步，但大多数患者的血糖控制仍未达到最佳状态。此外，包括儿童在内，相当高比例的T1D患者患有肥胖症。因此，需要新的干预措施，其效果集中在体重减轻上，以帮助改善相关的胰岛素抵抗并改善血糖控制。
胰高血糖素样肽-1受体激动剂（GLP-1 RAs）已被证明在患有T1D的成人中有效且安全，显示出血糖控制、体重和心脏肾脏保护方面的改善。GLP-1 RAs也被批准用于肥胖儿童（12岁以上）或2型糖尿病儿童（10岁以上）。然而，目前这些药物未被批准用于患有T1D的儿童。只有少数已发表的研究评估了它们在该适应症中的疗效和安全性。
本综述介绍了从随机对照试验（RCT）和真实世界数据中，对接受其他治疗的患有T1D的儿科和青少年患者加用GLP-1 RA治疗的基本原理和经验。GLP-1 RA在患有T1D的儿童中的研究结果仍未可知，而该人群中缺乏大型多中心随机对照试验（RCT）。
