For more than 100 years, nearly every major breakthrough in type 1 diabetes has focused on one thing: insulin.

From insulin pumps and continuous glucose monitors (CGMs) to automated insulin delivery systems, innovation has made insulin safer, smarter, and easier to use.

GLP-1 receptor agonists represent something fundamentally different. Rather than improving insulin delivery, they target biological pathways that insulin alone cannot address, influencing appetite, gastric emptying, satiety, and glucagon secretion. For many people living with type 1 diabetes, those effects address challenges that have long been accepted as simply "part of living with diabetes."

While no GLP-1 therapy is currently FDA-approved for type 1 diabetes, several late-stage clinical programs are underway, and the growing body of evidence has many in the diabetes community asking how these therapies could fit into type 1 diabetes management if future trials and regulators support broader use.

At Thrivable, we've been watching this evolution from another perspective: the patient experience. In our latest Thrivable 365 research, we analyzed more than 3,500 patient audio responses from 591 people living with diabetes—including people with type 1 diabetes—to better understand the real-world experience with GLP-1 therapy. Increasingly, we're seeing alignment between what people have been telling us for years and what the scientific literature is beginning to demonstrate.

The Science Is Catching Up to the Patient Experience

Long before randomized clinical trials were underway, many people living with type 1 diabetes were already using GLP-1 therapies off label. Online diabetes communities have consistently reported reduced insulin needs, fewer post-meal glucose excursions, weight loss, and perhaps most notably, relief from the constant "food noise" that can be difficult to describe.

Those experiences are increasingly being reflected in the scientific literature.

Our own research suggests awareness has evolved rapidly as well. Among people who started GLP-1 therapy before 2022, nearly 30% said they knew little or nothing about these medications before speaking with their healthcare provider. By 2025, that figure had dropped to just 8%. Yet awareness doesn't necessarily translate into preparedness. Even among recent starters, nearly 60% described having a neutral impression before beginning therapy, suggesting many entered treatment without a clear understanding of what to expect.

Recent systematic reviews and meta-analyses have found that adjunctive GLP-1 receptor agonist therapy in adults with type 1 diabetes can reduce body weight, lower total daily insulin requirements, modestly improve HbA1c, and increase time in range when used alongside insulin therapy.¹˒² Just as importantly, these benefits can be achieved without increasing severe hypoglycemia when insulin is proactively titrated and people receive appropriate education and follow-up.

That last point is critical. Success with GLP-1 therapy depends not only on the medication itself, but on giving people the tools and confidence to adjust insulin safely as their needs evolve.

Click the image to watch a recording of our webinar "The Great GLP-1 Shift: How Patient Mindset Is Reshaping Diabetes Care, Support, and Strategy".

Beyond Weight Loss

GLP-1 medications are often discussed through the lens of weight loss. For people living with type 1 diabetes, however, the story may be even broader.

One of the lesser-known consequences of type 1 diabetes is the loss of amylin, a hormone produced alongside insulin that helps regulate gastric emptying and signals fullness after meals. Without it, many people experience persistent hunger and reduced satiety. By slowing gastric emptying and increasing satiety, GLP-1 therapies may help address some of these physiological gaps while reducing the "food noise" people frequently describe.

Many of these benefits aren't fully captured by traditional clinical endpoints like HbA1c or time in range, but they consistently emerge when people describe their lived experience.

That finding echoes what we've heard through Thrivable's own research. Across hundreds of GLP-1 users, people frequently described benefits extending well beyond glycemic outcomes—including less anxiety, greater confidence, and a reduced mental burden associated with diabetes. In fact, improvements in mental health—not weight loss or insulin reduction—were the strongest predictor of a person's intention to remain on therapy long term. For many, the greatest benefit wasn't simply better numbers; it was feeling like diabetes occupied less of their daily lives.

Approval Is Only the Beginning

If GLP-1 therapies ultimately receive FDA approval for type 1 diabetes, that milestone should be viewed as the beginning—not the end—of the work.

One of the most consistent findings across studies is that GLP-1 therapy reduces insulin requirements. As insulin sensitivity improves and food intake decreases, insulin dosing often needs to be adjusted—a process that varies considerably from person to person.

This is where education becomes just as important as the prescription itself. In our own research, 66.5% of people said their healthcare provider first introduced GLP-1 therapy, yet relatively few recalled discussing topics such as titration or side-effect management before starting treatment. As GLP-1 therapies become more common in type 1 diabetes, those conversations will be essential to helping people safely adjust insulin while minimizing the risk of hypoglycemia or ketosis.

Continuous glucose monitoring will likely play an equally important role, giving people and their care teams the information they need to make informed insulin adjustments as therapy evolves.

Of course, realizing these benefits will also depend on ensuring people can actually access these therapies. Broader insurance coverage will be an important step, but meaningful adoption will ultimately require affordability alongside education and clinical support.

Listening to Patients While the Evidence Evolves

At Thrivable, we believe people often experience the future before the healthcare system catches up. By listening to people living with chronic disease at scale, we often hear themes years before they become mainstream scientific conversations.

Increasingly, we're seeing alignment between what people have been sharing for years and what clinical trials are now beginning to demonstrate.

If GLP-1 therapies are ultimately approved for type 1 diabetes, their success won't depend on the medication alone. It will depend on ensuring people have access to the education, technology, and clinical support needed to use them safely and confidently.

For life sciences teams, that makes the patient experience more than a reflection of what is happening today. It is an early signal of what support, messaging, evidence generation, and access strategies may need to look like tomorrow.