Glucagon-like peptide-1 agonists in children with obesity and type 2 diabetes. an umbrella review

Introduction: Obesity and type 2 diabetes mellitus (Type 2 DM) are rising at an alarming rate among children and adolescents. This population often exhibits suboptimal glycemic control and diabetes-related complications. Glucagon-like peptide-1 receptor agonists (GLP-1 agonists) have emerged as a promising therapeutic option for pediatric patients due to their beneficial effects on weight reduction and glycemic regulation. Literature on this important issue is scarce. We aimed to assess the effects of GLP-1 agonists on body weight, HbA1c, body mass index z (BMI z), and systolic blood pressure (SBP). Additionally, we discussed adverse events and hypoglycemia. Methods: We searched PubMed/MEDLINE, Web of Science, and the Cochrane Library from October to November 2025 using the following terms: GLP-1 agonists, semaglutide, tirzepatide, liraglutide, exenatide, children, obesity, adolescents, blood pressure, BMI z, hypoglycemia, body weight, and HbA1c. We retrieved 1600 articles. Out of the 44 reviews found, only 11 meta-analyses were included in the final results. Results: GLP-1 agonists were more effective than control in reducing body weight, HbA1c, BMI z, and blood pressure, MD = 0.11, 95% CI 0.05-0.25, MD = 0.65, 95% CI 0.53-0.80, MD = 0.85, 95% CI 0.81-0.90, and MD = 0.19, 95% CI 0.04-83, respectively. The total adverse events and hypoglycemia were not different, log ratios=1.29, 95% CI 0.80-2.09, and log ratios=1.26, 95% CI 0.59-2.70, respectively. Discussion: GLP-1 agonists are a promising and effective therapy for lowering weight, HbA1c, BMI z, and SBP in adolescents with obesity or youth with type 2 DM. Moreover, GLP-1 agonists were well tolerated, and the total adverse events and hypoglycemia were comparable to those of controls.