Effect of liraglutide on subclinical atherosclerosis and cardiometabolic risk factors in adults with type 1 diabetes: A prospective pilot study

Abstract Aims To evaluate the effect of liraglutide on carotid intima–media thickness (CIMT) and cardiometabolic risk in adults with type 1 diabetes (T1D). Methods We conduct a prospective, quasi‐experimental study including adults aged 15–60 years with T1D, suboptimal control and on basal‐bolus insulin regimen. Participants received liraglutide 1.8 mg/day for 24 weeks. Anthropometric measurements, laboratory parameters, insulin sensitivity (estimated glucose disposal rate, eGDR) and CIMT (high‐resolution B‐mode ultrasonography) were assessed at baseline, 12 and 24 weeks. Paired t ‐tests, Wilcoxon‐signed rank tests and McNemar's tests were used for statistical comparisons. Results Thirty‐five participants (median age 36 years; 57.1% women) were included. Baseline mean HbA1c was 67 mmol/mol (8.3%), CIMT 0.54 ± 0.13 mm, and median diabetes duration 11 years. After 24 weeks, liraglutide did not significantly modify CIMT (0.54 vs. 0.58 mm; p = 0.151). However, significant improvements were observed in waist circumference (82.5–79 cm; p = 0.004), body weight (70–66.7 kg; p < 0.001), BMI (25.5–24.3 kg/m 2 ; p < 0.001), triglycerides (94–75 mg/dL; p = 0.02) and eGDR (7.9–8.9 mg/kg/min; p = 0.003). HbA1c improved at 12 weeks but was not sustained at week 24. No severe hypoglycaemia, diabetic ketoacidosis, emergency visits or hospitalizations occurred. Conclusions In adults with T1D, liraglutide improved several cardiometabolic risk factors and insulin sensitivity, although no significant short‐term effects on CIMT were observed. Larger long‐term trials are needed to clarify its potential role in cardiovascular prevention in this population.