GLP-1 (glucagon-like peptide-1) drugs are widely recognized for their role in weight loss, but they were initially developed for diabetes treatment and remain extensively used for this purpose.
Researchers have now identified a unique benefit of GLP-1 treatments for a rare type of diabetes associated with a blood disorder known as transfusion-dependent beta-thalassaemia (TDT).
In individuals with TDT diabetes, excess iron accumulation harms the pancreas, hindering its ability to produce insulin effectively.
A study led by Ain Shams University in Egypt, and published in Diabetologia, found that the GLP-1 drug dulaglutide outperformed standard insulin doses in treating TDT diabetes, according to various health metrics.
This suggests that a weekly GLP-1 injection could replace daily insulin injections, greatly simplifying the treatment regimen for this condition.
“The glucagon-like peptide-1 receptor agonist dulaglutide therapy was associated with greater improvements in glycaemic control and variability compared with insulin among adolescents with TDT-induced diabetes, without risk of hypoglycemia or compromising safety,” write the researchers in their published paper.
TDT is a genetic disorder where the body’s red blood cells cannot carry sufficient oxygen. As the condition’s name implies, regular blood transfusions are necessary, leading to iron imbalances and pancreatic issues.

Over time, TDT can result in diabetes, but it’s neither type 1 nor type 2 diabetes—instead, it combines elements of both.
Since dulaglutide is already used for type 2 diabetes, researchers aimed to assess its effectiveness in TDT diabetes.
They conducted a study involving 80 young participants with TDT diabetes, aged 10 to 18, who did not respond to the commonly prescribed diabetes drug metformin.
The participants were divided into two groups: one received weekly dulaglutide injections, while the other received daily insulin shots. Their health metrics were monitored over a 24-week period.
“Participants were instructed to refrain from substantial changes in their lifestyle habits throughout the study period,” write the researchers.
The dulaglutide treatment proved superior.
Participants on dulaglutide experienced fewer fluctuations in blood sugar levels, larger reductions in average blood sugar levels, and more time in healthy glucose zones.
Additional health markers supported these findings. Unlike the insulin group, those on dulaglutide did not experience significant weight gain, and there were indications that the GLP-1 drug might also reduce iron overload.
While these findings are preliminary, they hold promise.

“The current study has several strengths,” write the researchers.
“It is the first to assess the efficacy of dulaglutide in adolescents with TDT-induced diabetes, providing insight into a promising therapeutic modality for this vulnerable population.”
“Moreover, it assessed the effect of dulaglutide on pancreatic reserve, iron overload and lipid profile.”
GLP-1 treatments mimic the natural glucagon-like peptide-1 hormone, stimulating the pancreas to produce more insulin, slowing digestion, and reducing glucose release from the liver, all of which help manage blood sugar levels.
These GLP-1 drugs have already replaced insulin injections in some diabetes cases. The significant aspect here is that TDT diabetes impairs the pancreas and insulin production. GLP-1 drugs appear to support the remaining natural insulin production processes rather than simply adding more insulin.
Related: A Distinct New Type of Diabetes Is Now Officially Recognized
However, more research is needed, and the researchers are eager to test dulaglutide on larger groups to better understand how GLP-1 agonists might aid in regulating blood sugar and reducing iron levels.
Researchers continue to uncover unexpected effects of these treatments, all of which need to be thoroughly understood to ensure proper prescription.
“Future larger prospectively registered multicenter studies with extended follow-up are warranted to validate these findings and explore the mechanistic pathways,” write the researchers.
The study has been published in Diabetologia.
This article was fact-checked by Rachel Garner and edited by Peter Dockrill. While we pride ourselves on our process, we are only human. If you spot a mistake, please let us know.

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