What Happens to Blood Sugar Control When Semaglutide Is Stopped? New Research Offers Clues

Researchers wanted to know what happens to blood sugar control when people with Type 1 diabetes stop taking semaglutide, a medication that was being tested as a potential add-on to insulin and automated insulin delivery systems. This new analysis comes from an extension phase of the ADJUST-T1D trial, a larger research project that studied semaglutide in adults with Type 1 diabetes and obesity.

The study followed two groups of participants for 12 weeks after the main trial ended: 16 people who had been taking semaglutide and then stopped, and 22 people who had been on placebo throughout. Researchers used continuous glucose monitoring (CGM) data to track how their blood sugars changed.

When participants stopped semaglutide, their time in the target glucose range fell by 3.6 percentage points more than it did in the placebo group, which actually stayed relatively stable. In practical terms, this means people who discontinued semaglutide spent less time with their blood sugar in the healthy target zone.

The study also found that blood sugar became less stable after semaglutide was stopped. Glucose standard deviation—a measure of how much blood sugar bounces around—increased by 6.0 mg/dL in the semaglutide discontinuation group compared to 1.2 mg/dL in placebo. A similar pattern appeared in coefficient of variation, another measure of glucose variability. These changes suggest that stopping the medication was associated with more unpredictable blood sugar swings.

High blood sugar episodes (above 180 mg/dL) showed a numerical increase after semaglutide was discontinued, but this difference was not statistically significant after statistical adjustment. Low blood sugar events did not show meaningful differences between the groups.

This analysis provides early evidence about what to expect if semaglutide is discontinued in people with Type 1 diabetes who use automated insulin delivery systems. The results suggest that stopping the medication may be associated with a decline in time spent in range and an increase in glucose variability—factors that matter for overall diabetes management and long-term health.

It's important to note that this study involved a relatively small number of participants (38 people total) and only followed them for 12 weeks. The findings add useful information to ongoing research about semaglutide in Type 1 diabetes, but they do not provide guidance for individual treatment decisions. Anyone considering starting or stopping any diabetes medication should work closely with their care team.

Source: Diabetes, obesity & metabolism. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.