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Randomized Controlled Trial
. 2025 Dec 1;48(12):2154-2159.
doi: 10.2337/dc25-1753.

Additive Benefits of Control-IQ+ AID to GLP-1 Receptor Agonist Use in Adults With Type 2 Diabetes

Timothy E Graham  1 , Dan Raghinaru  2 , Samina Afreen  3 , Andrew Ahmann  4 , Ahmad Haidar  5 , Philip Raskin  6 , Michael A Tsoukas  5 , John W Lum  2 , Ravid Sasson-Katchalski  7 , Jordan E Pinsker  7 , Roy W Beck  2 ; 2IQP Study Group*
Collaborators, Affiliations
Randomized Controlled Trial

Additive Benefits of Control-IQ+ AID to GLP-1 Receptor Agonist Use in Adults With Type 2 Diabetes

Timothy E Graham et al. Diabetes Care. .

Abstract

Objective: To assess the effect of automated insulin delivery (AID) on glycemic and insulin outcomes in adults with insulin-treated type 2 diabetes using a glucagon-like peptide-1 receptor agonist (GLP-1 RA).

Research design and methods: In a randomized trial comparing Control-IQ+ AID versus continuation of prestudy insulin delivery method plus continuous glucose monitoring (CGM group), 143 (45%) of the 319 participants were using a GLP-1 RA at baseline, which was continued during the trial.

Results: Among GLP-1 RA users, mean HbA1c decreased by 0.8% from a baseline of 8.0 ± 1.2% with AID, which represented a mean improvement of -0.5% (95% CI -0.8 to -0.3, P < 0.001) compared with the CGM group. Time-in-range 70-180 mg/dL and other CGM metrics reflective of hyperglycemia also showed comparable statistically significant improvements using AID when added to GLP-1 RA use. For GLP-1 RA users, there was no significant difference in weight after 13 weeks with AID compared with the CGM group (0.9 kg, 95% CI -0.2 to 2.1, P = 0.10), whereas, in GLP-1 RA nonusers, there was a mean weight gain of 1.9 kg with AID compared with CGM (95% CI 0.5 to 3.2, P = 0.007).

Conclusions: The benefits of AID appear to be substantial for a broad spectrum of insulin-treated patients with type 2 diabetes, including those already receiving contemporary and guideline-directed therapy, such as a GLP-1 RA medication. These additive benefits of AID in GLP-1 RA users included significant reductions in HbA1c levels with simultaneous reduction in insulin use, along with no statistical increase in weight despite very significant improvements in glycemic control.

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Conflict of interest statement

Duality of Interest. S.A. reports receiving grants from Tandem Diabetes Care. A.A. reports receiving consultancy payments from Medtronic MiniMed. A.H. reports receiving consultancy fees from Eli Lilly and Abbott and research support from Dexcom, Tandem Diabetes Care, Ypsomed, and BetaBionics. M.A.T. reports receiving speaker fees from Boehringer Ingelheim Canada, Eli Lilly, Janssen Pharmaceuticals, Novo Nordisk, and Sanofi. J.W.L. reports receiving grants from Dexcom and grants and consultancy payments from Tandem Diabetes Care. R.S.-K. is an employee of Tandem Diabetes Care. J.E.P. is an employee and shareholder of Tandem Diabetes Care. R.W.B. reports that his institution has received funding on his behalf as follows: grant funding, study supplies, and consulting fees from Insulet, Tandem Diabetes Care, and Beta Bionics; grant funding and study supplies from Dexcom and Abbott; grant funding from Bigfoot Biomedical, embecta, Sequel Med Tech, and MannKind; study supplies from Medtronic; consulting fees and study supplies from Novo Nordisk; and consulting fees from Vertex, Hagar, DreaMed Diabetes, Ypsomed, Abata Therapeutics, Eli Lilly, and Zucara Therapeutics. No other potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Change in HbA1c from baseline to 13 weeks among participants using GLP-1 RA medications at baseline versus not using GLP-1 RA medications, by treatment group.
See this image and copyright information in PMC

References

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