Last updated September 12, 2026
Key finding
Triple therapy reduced HbA1c by 1.5% compared to dual therapy.
This study evaluated the efficacy and safety of adding a GLP-1 receptor agonist and SGLT2 inhibitor to insulin therapy in Type 1 Diabetes, finding significant improvements in HbA1c and quality of life.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Short-Term (≤3 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the efficacy and safety of adding a GLP-1 receptor agonist and SGLT2 inhibitor to insulin therapy in Type 1 Diabetes, finding significant improvements in HbA1c and quality of life.
These findings are significant as they suggest that integrating newer diabetes medications with insulin therapy can lead to better glycemic control and improved patient-reported outcomes. This could inform treatment strategies for managing Type 1 Diabetes, potentially leading to better long-term health outcomes.
Unclear effectiveness for some outcomes. Limited generalizability due to specific population characteristics. Potential for unmeasured confounding factors.
Published in
Publication details and source links for this paper.
Joseph GT, Husam G, James GB, et al. Efficacy and safety of adding a GLP-1 receptor agonist and SGLT2 inhibitor to insulin therapy in Type 1 Diabetes. Diabetes, Obesity & Metabolism. 2026;28(10):8812-8824. doi:10.1111/dom.71076
Triple therapy with dapagliflozin, semaglutide, and insulin reduced HbA1c by 1.5% (p=0.01).
Quality of life improved by 10 points (p=0.03) with triple therapy.
No significant difference in the rate of hypoglycaemic events (0.2 events, p=0.45).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Dapagliflozin and Semaglutide and Insulin, Insulin therapy and Diabetic ketoacidosis, Fasting blood sugar (FBS), HbA1c, and 3 more.
This study contributes evidence to
Primary intervention
Dapagliflozin and Semaglutide and Insulin
Primary outcomes
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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7
Evidence pairs
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Primary evidence
Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Dapagliflozin and Semaglutide and Insulin → Diabetic ketoacidosis
Dapagliflozin and Semaglutide and Insulin → Diabetic ketoacidosis
Dapagliflozin and Semaglutide and Insulin → Fasting blood sugar (FBS)
Dapagliflozin and Semaglutide and Insulin → Fasting blood sugar (FBS)
Dapagliflozin and Semaglutide and Insulin → HbA1c
Dapagliflozin and Semaglutide and Insulin → HbA1c
Dapagliflozin and Semaglutide and Insulin → Number of hypoglycaemic episodes
Dapagliflozin and Semaglutide and Insulin → Number of hypoglycaemic episodes
Dapagliflozin and Semaglutide and Insulin → Quality of life
Dapagliflozin and Semaglutide and Insulin → Quality of life
Dapagliflozin and Semaglutide and Insulin → Time in range
Dapagliflozin and Semaglutide and Insulin → Time in range
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Insulin Therapies and HbA1c, Insulin Therapies and CGM Time in Range.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Medications
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on Insulin Therapies
Contributes to Insulin Therapies evidence base.
All studies measuring CGM Time in Range
Measures CGM Time in Range as a key outcome.
All studies on Dapagliflozin and Semaglutide and Insulin
Contributes to Dapagliflozin and Semaglutide and Insulin evidence base.
All studies measuring Quality of Life Outcomes
Measures Quality of Life Outcomes as a key outcome.
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8 results
5 results
8 results
1 results
8 results
Generated from the study's connected evidence using Evidence Intelligence™.
Insulin Therapies may lower HbA1c.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 85.2 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study
Why this answer: This answer is based on 19 supporting studies with generally consistent results and a positive effect signal.
Dapagliflozin and Semaglutide and Insulin appears to lower HbA1c.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Dapagliflozin and Semaglutide and Insulin appears to improve quality of life.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Quality of life
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Dapagliflozin and Semaglutide and Insulin appears to improve time in range.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Time in range
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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