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NCT05537233: ADJUST-T1D

ADJUnct Semaglutide Treatment in Type 1 Diabetes

Completed Phase 2 Results posted Last updated 3 September 2025
What this trial tests

Phase 2 trial testing Semaglutide in Type 1 Diabetes in 115 participants. Completed in 6 August 2024.

Timeline
11 April 2023
Primary endpoint
6 August 2024
6 August 2024

Quick facts

Lead sponsorViral N. Shah
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment115
Start date11 April 2023
Primary completion6 August 2024
Estimated completion6 August 2024
Sites4 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Viral N. Shah

Who can join

Adults 18 to 65, any sex, with Type 1 Diabetes or Obesity. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Proportion of Adults With T1D Achieving Composite Outcome (CGM-measured Time in Range (TIR)>70% With Time Below Range (TBR) of <4% and Reduction in Body Weight by 5%) at 26 Weeks in the Semaglutide Group Compared to Placebo Group Primary · 26 weeks

Primary outcome will be analyzed per statistical analysis plan using intention to treat basis.

GroupValue95% CI
Semaglutide13
Control0
Change in HbA1c Secondary · 26 weeks

HbA1c will be measured at a central laboratory and change in Hba1c from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide-0.7± 0.1
Control-0.4± 0.1
Change in Mean Glucose Secondary · 26 weeks

Mean glucose (mg/dL) will be obtained by CGM and change in mean CGM glucose from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide-15.7± 2.6
Control-3.6± 2.8
Percent Time Spent in CGM-measured Glucose Range of 70-140 mg/dL (Time in Tight Target Range; TTIR) Secondary · 26 weeks

Percent of time spent in tight glucose range (70-140 mg/dL) will be obtained by CGM and change in percent time in range from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide9.8± 1.7
Control2.9± 1.8
Percent Time Spent in CGM-measured Glucose >180 mg/dL Secondary · 26 weeks

Percent of time spent in glucose range \>180 mg/dL will be obtained by CGM and change in mean CGM glucose from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide-11.1± 1.8
Control-2.7± 1.9
Percent Time Spent in CGM-measured Glucose >250mg/dL Secondary · 26 weeks

Percent of time spent in glucose range \>250 mg/dL will be obtained by CGM and change in mean CGM glucose from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide-5.1± 1.1
Control-0.5± 1.2
Percent Time Spent in CGM-measured Glucose <70mg/dL Secondary · 26 weeks

Percent of time spent in glucose range \<70 mg/dL will be obtained by CGM and change in mean CGM glucose from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide0.1± 0.2
Control0.4± 0.2
Change in CGM Measured Glycemic Variability (Coefficient of Variation) Secondary · 26 weeks

Glucose coefficient of variation (mg/dL) will be obtained by CGM and change in glucose CV from baseline to 26 weeks will be compared by randomization group using intention to treat (ITT) analysis.

GroupValue95% CI
Semaglutide-0.3± 0.8
Control0.9± 0.9
Change in Weight Secondary · 26 weeks

The change in kg of body weight from baseline to 26 weeks will be compared by randomization group using an ITT analysis.

GroupValue95% CI
Semaglutide-9.2± 0.7
Control-0.4± 0.6
Change in BMI (Kg/m2) Secondary · 26 weeks

Change in body mass index (BMI) calculated as kg body weight per meter squared of height from baseline to 26 weeks will be compared by randomization group using an ITT analysis.

GroupValue95% CI
Semaglutide-3.3± 0.3
Control-0.2± 0.2
Severe Hypoglycemia Secondary · 26 weeks

SH events in number of patients per group

GroupValue95% CI
Semaglutide2
Control2

Adverse events — posted to ClinicalTrials.gov

Time frame: from signing consent from till end of the study (i.e 26 weeks). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Semaglutide
Serious: 1/36 (3%)
Deaths: 0/36
Control
Serious: 0/36 (0%)
Deaths: 0/36

Serious adverse events (1 terms)

ReactionSystemSemaglutideControl
Nausea & vomitingGastrointestinal disorders
Other adverse events (3 terms — click to expand)

ReactionSystemSemaglutideControl
Gastrointestinal eventsGastrointestinal disorders
COVID-19Infections and infestations
Upper respitory infectinInfections and infestations

Most-reported serious reactions: Nausea & vomiting.

Data from ClinicalTrials.gov NCT05537233 adverse events section.

Sponsor's own description

The purpose of this study is to assess the use of once weekly semaglutide injection in inadequately controlled obese adults with type 1 diabetes (T1D) using FDA-approved hybrid closed-loop therapies.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. The emergence of obesity in type 1 diabetes.
    Kueh MTW, Chew NWS, Al-Ozairi E, le Roux CW. · · 2024 · cited 57× · PMID 38092958 · DOI 10.1038/s41366-023-01429-8
  2. Semaglutide in Adults with Type 1 Diabetes and Obesity.
    Shah VN, Akturk HK, Kruger D, Ahmann A, et al · · 2025 · cited 19× · PMID 40550013 · DOI 10.1056/evidoa2500173
  3. Metabolic interventions as adjunctive therapies to insulin in type 1 diabetes: Current clinical landscape and perspectives.
    Podobnik J, Prentice KJ. · · 2025 · cited 5× · PMID 39757938 · DOI 10.1111/dom.16154
  4. Managing obesity in adults with type 1 diabetes.
    Campos A, Gutierrez RR, Galindo RJ, McCoy RG, et al · · 2025 · cited 5× · PMID 39746549 · DOI 10.1016/j.diabres.2024.111983
  5. Combining SGLT2is, GLP1-RAs and nsMRAs in Diabetes: A Scoping Review of Current and Future Perspectives.
    Stougaard EB, Curovic VR, Hansen TW. · · 2025 · cited 3× · PMID 40088324 · DOI 10.1007/s13300-025-01726-7
  6. Recent Updates on Diabetes and Bone.
    Brunetti G. · · 2025 · cited 2× · PMID 40943066 · DOI 10.3390/ijms26178140
  7. Use of adjunctive glycaemic agents with vascular protective properties in individuals with type 1 diabetes: Potential benefits and risks.
    Rajab AM, Pearson S, Ajjan RA. · · 2025 · cited 2× · PMID 40130476 · DOI 10.1111/dom.16332
  8. 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.
    Karakus KE, Akturk HK, Kruger D, Ahmann A, et al · · 2026 · cited 1× · PMID 41429002 · DOI 10.2337/dc25-2249

Verify or expand the search:

Other trials of Semaglutide

Trials testing the same drug.

Other recruiting trials for Type 1 Diabetes

Currently open trials in the same condition.

Other Viral N. Shah trials

Trials by the same sponsor.

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT05537233.

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