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NCT Number: NCT06909006

Semaglutide Treatment in Type 1 Diabetes

The goal of this clinical trial is to investigate the efficacy of semaglutide on body weight, insulin dose requirements and improvements in glucose control and safety aspects in regards to risk of hypoglycemia and diabetic ketoacidosis for patients with established Type 1 Diabetes.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Nordsjaellands Hospital

Hillerød, Denmark, 3400

Location contact

Hasan I Mirza, MD, ph.d.-student

CONTACT

[email protected]

0045 42 37 58 40

Hasan I Mirza, MD, ph.d.-student

SUB_INVESTIGATOR

Thomas F Dejgaard, MD, ph.d., endocrinologist

CONTACT

[email protected]

0045 26 79 61 03

Thomas F Dejgaard, MD, ph.d., endocrinologist

PRINCIPAL_INVESTIGATOR

About this study

This is a multicentre, randomised, double-blinded, placebo-controlled and investigator-initiated trial aimed to investigate the efficacy of semaglutide in patients with Type 1 Diabetes.

Patients from all included diabetes care centres will at routine visits be screened for eligibility for the trial and offered participation. If accepted, the patients will be randomised to one of two intervention arms and undergo a series of different examinations prior to start of the intervention.

The two arms consist of treatment with subcutaneous semaglutide injections or subcutaneous injections with semaglutide placebo. The baseline examinations entail documentation of insulin doses, dietary patterns, diabetes distress and treatment satisfaction questionnaires, anthropoimetric data (height, weight and calculation of BMI, waist circumference, waist-hip-ratio), blood work (HbA1c, fasting glucose, fasting c-peptide, lipids, liver and kidney markers incl. Fib-4-scoring, hematology, hsCRP), ECG, capturing of data from continuous/flash glucose monitors.

The first 40 included in the study from the centres of SDCA and NOH will further be examined through hyperinsulinemic euglycemic clamps to determine their insulin sensitivity and asses their transcriptome through muscle and fat cell biopsies in relation to the clamp and also be assessed through DXA scans to look at body composition and bone density.

Patients will then be handed out their trial drug-pens and start the uptitration proces.

The efficacy of semaglutide will be evaluated through the above mentioned array of different investigations by comparing parameters prior to trial drug start, during (throughout the study period), at the end of the drug and at a 6 week post-study followup in an intention-to-treat analysis primarily and secondarily a per-protocol analysis.

The safety will be assessed through evaluation of standardized adverse event reporting (including hypoglycemic events and diabetic ketoacidosis).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Type 1 Diabetes for more than 3 years
  • BMI ≥ 30 or ≥ 27 and atleast one comorbidity (hypertension, hypercholesterolemia, microalbuminuria, ischemic heart disease, history of stroke, atherosclerosis or arthrosis

Exclusion criteria

  • Treated with GLP1-RAs within last 6 months
  • Known intolerance for semaglutide
  • Other forms of diabetes
  • Pregnant or nursing women
  • Fertile women not using chemical (hormonal) or mechanical (spiral) contraceptives
  • Liver disease with elevated plasma alanine aminotransferase (ALT) > five times and plasma aspartate aminotransferase (AST) > five times the upper limit of normal (measured at visit 0 with the possibility of one repeat analysis within a week, and the last measured value as being conclusive)
  • Acute or chronic pancreatitis
  • Cancer, unless in complete remission for > 5 years or unless basocellular carcinomas
  • History of thyroid adenoma or carcinoma
  • Alcohol/drug abuse
  • Other concomitant disease or treatment that according to the investigator's assessment makes the patient unsuitable for study participation
  • Receipt of an investigational drug within 30 days prior to visit 0 / Simultaneous participation in any other clinical intervention trial

Treatment and study plan

Semaglutide 2.4mg

Drug

The active comparator of the intervention is s.c. Semaglutide injection once a week in increasing doses every month from 0.25 mg to 0.5 mg to 1.0 mg to 1.7 mg to 2.4 mg and the placebo comparator is s.c. injection with a visually identical and same label pen as described for the active comparator

Other names: Active semaglutide

Semaglutide Placebo

Drug

Visually identical and same label as the active comparator intervention

Other names: Placebo semaglutide

Primary outcomes

  1. Body weight

    Time frame: 74 weeks

    Body weight will be measured both prior to and following treatment for 68 weeks with either semaglutide or placebo. Changes in body weight will be compared for the two intervention arms, before, throughout and at the end of treatment and then at followup 6 weeks later.

Secondary outcomes

  1. Systolic blood pressure

    Time frame: 74 weeks

    Systolic blood pressure will be assessed at randomization and evaluated for changes throughout, at the end of treatment and at followup 6 weeks later.

  2. Diastolic blood pressure

    Time frame: 74 weeks

    Diastolic blood pressure will be assessed at randomization and evaluated for changes throughout, at the end of treatment and at followup 6 weeks later.

  3. Resting heart rate

    Time frame: 74 weeks

    Systolic blood pressure will be assessed at randomization and evaluated for changes throughout, at the end of treatment and at followup 6 weeks later.

  4. Waist circumference

    Time frame: 74 weeks

    Waist circumference will be assessed and evaluated for changes during and after treatment for 68 weeks with semaglutide compared to before treatment.

  5. Hip-waist-ratio

    Time frame: 74 weeks

    Hip-waist-ratio will be assessed and evaluated for changes during and after treatment for 68 weeks with semaglutide compared to before treatment.

  6. Hemoglobin

    Time frame: 74 weeks

    Blood samples will be analyzed to assess hemoglobin before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  7. Leucocytes

    Time frame: 74 weeks

    Blood samples will be analyzed to assess leucocytes levels before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  8. Thrombocytes

    Time frame: 74 weeks

    Blood samples will be analyzed to assess thrombocytes levels before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  9. HbA1c

    Time frame: 74 weeks

    Blood samples will be analyzed to assess HbA1c before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  10. Fasting plasma-glucose

    Time frame: 74 weeks

    Blood samples will be analyzed to assess fasting plasma-glucose before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  11. Fasting c-peptide

    Time frame: 74 weeks

    Blood samples will be analyzed to assess fasting c-peptide before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  12. Total cholesterol

    Time frame: 74 weeks

    Blood samples will be analyzed to assess total cholesterol before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  13. HDL cholesterol

    Time frame: 74

    Blood samples will be analyzed to assess HDL cholesterol before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  14. LDL cholesterol

    Time frame: 74 weeks

    Blood samples will be analyzed to assess LDL cholesterol before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  15. VLDL cholesterol

    Time frame: 74 weeks

    Blood samples will be analyzed to assess VLDL cholesterol before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  16. Triglycerides

    Time frame: 74 weeks

    Blood samples will be analyzed to assess triglycerides levels before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  17. non-HDL cholesterol

    Time frame: 74 weeks

    Blood samples will be analyzed to assess non-HDL cholesterol before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  18. Sodium

    Time frame: 74 weeks

    Blood samples will be analyzed to assess sodium before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  19. Potassium

    Time frame: 74 weeks

    Blood samples will be analyzed to assess potassium before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  20. Creatinine/eGFR

    Time frame: 74 weeks

    Blood samples will be analyzed to assess creatinine levels to calculate estimated Glomerular Filtration Rates (eGFR, based on sex, age and creatinine leve) before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  21. Alanine transaminase (ALT)

    Time frame: 74 weeks

    Blood samples will be analyzed to assess alanine transaminase (ALT) before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  22. Aspartate transaminase (AST)

    Time frame: 74 weeks

    Blood samples will be analyzed to assess aspartate transaminase (AST) before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  23. Fibrosis-4-score (Fib-4)

    Time frame: 74 weeks

    Blood samples will be analyzed for fibrosis-4-scores (based on age, thrombocytes, ALT and AST) before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  24. Amylase

    Time frame: 74 weeks

    Blood samples will be analyzed to assess pancreatic amylase before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  25. Lipase

    Time frame: 74 weeks

    Blood samples will be analyzed to assess pancreatic lipase before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  26. High sensitivity C-reactive protein (hsCRP)

    Time frame: 74 weeks

    Blood samples will be analyzed to assess high sensitivity C-reactive protein (hsCRP) before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  27. Albumin

    Time frame: 74 weeks

    Blood samples will be analyzed to assess serum albumin before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  28. Ketones

    Time frame: 74 weeks

    Blood samples will be analyzed to assess total serum ketones before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up

  29. CGM data - Time in range (TIR)

    Time frame: 68 weeks

    Data from CGMs will be analyzed to asses time in range (TIR) before treatment and evaluated for changes in TIR throughout the 68-week regimen and at its conclusion.

  30. CGM data - Time in tight range (TITR)

    Time frame: 68 weeks

    Data from CGMs will be analyzed to asses time in tight range (TITR) before treatment and evaluated for changes in TITR throughout the 68-week regimen and at its conclusion.

  31. CGM data - Time above range (TAR)

    Time frame: 68 weeks

    Data from CGMs will be analyzed to asses time above range (TAR) before treatment and evaluated for changes in TAR throughout the 68-week regimen and at its conclusion.

  32. CGM data - Time below range (TBR)

    Time frame: 68 weeks

    Data from CGMs will be analyzed to asses time in range (TBR) before treatment and evaluated for changes in TBR throughout the 68-week regimen and at its conclusion.

  33. CGM data - coefficient of variation (CV)

    Time frame: 68 weeks

    Data from CGMs will be analyzed to asses coefficient of variation (CV) before treatment and evaluated for changes in CV throughout the 68-week regimen and at its conclusion.

  34. Total daily dose of insulin

    Time frame: 74 weeks

    Total daily dose will be assessed at randomization and evaluated for changes throughout treatment regimen, at the end of study and at six weeks followup through the use of insulin dose diaries.

  35. Insulin sensitivity

    Time frame: 68 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: Insulin sensitivity will be assessed through the golden standard hyperinsulinemic euglycemic clamping method. This will be done before treatment and at the end of treatment.

  36. Fat percentage

    Time frame: 68 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: The fat percentage is measured by DXA scan at randomisation and at end-of-treatment.

  37. Lean mass

    Time frame: 68 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: Lean body mass is measured by DXA scan at randomisation and at end-of-treatment.

  38. Bone density (through bone mineral content)

    Time frame: 68 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: Bone density (through bone mineral content) is measured by DXA scan at randomisation and at end-of-treatment.

  39. Omics / Metabolome

    Time frame: 74 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: Blood samples will be analyzed to assess metabolomic profile (entailing both lipidome and proteome) before treatment and evaluated for changes throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up

  40. Muscle tissue biopsy

    Time frame: 68 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: Muscle tissue biopsies will be taken to assess changes in transcriptome at randomisation and at end-of-treatment.

  41. Fat tissue biopsy

    Time frame: 68 weeks

    For a subgroup consisting of the first 40 patients from two specified sites: Fat tissue biopsies will be taken to assess changes in transcriptome at randomisation and at end-of-treatment.

  42. Electrocardiogram

    Time frame: 68 weeks

    Electrocardiograms (ECG) will be recorded at initiation and end of treatment period to assess and evaluate if any rhytm changes occur.

Other outcomes

  1. Patient reported outcome measures - Dietary patterns

    Time frame: 74 weeks

    Questionnaires (DNBCs FFQ) will be analyzed to evaluate changes in dietary patterns before treatment, throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  2. Patient reported outcome measures - Diabetes treatment satisfaction

    Time frame: 74 weeks

    Questionnaires (DTSQ-s and DTSQ-c) will be analyzed to evaluate changes in diabetes treatment satisfaction before treatment, throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  3. Patient reported outcome measures - Diabetes distress

    Time frame: 74 weeks

    Questionnaires (PAID) will be analyzed to evaluate changes in diabetes treatment satisfaction before treatment, throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

  4. Adverse events

    Time frame: 74 weeks

    Tolerability will be assessed through standardized adverse event reporting (including episodes of hypoglycemia) throughout the 68-week regimen, at its conclusion, and again six weeks post-treatment during follow-up.

Study contacts

Contact information is provided by the study sponsor or research team.

Hasan I Mirza, MD, ph.d.-student

CONTACT

[email protected]

0045 42 37 58 40

Thomas F Dejgaard, MD, ph.d., endocrinologist

CONTACT

[email protected]

0045 26 79 61 03

Sponsors and collaborators

Lead sponsor

Nordsjaellands Hospital

Other

Collaborators

  • Aarhus University Hospital
  • Steno Diabetes Center Copenhagen
  • Steno Diabetes Center Odense
  • Zealand University Hospital

Registry information

Official study title

Obesity and Semaglutide in Type 1 Diabetes Therapy: A Multicentre, Randomised, Double-Blinded, Placebo-Controlled, Investigator-Initiated Trial

Acronym: OBES1TY

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Apr 3, 2025
Registry last updated
Aug 8, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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