804-P: Understanding Off-Label Use of GLP-1 (Glucagon-Like Peptide-1 Receptor) Agonists among Providers Participating in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)

Background: The use of glucagon-like peptide-1 agonists (GLP-1a) as adjunctive therapy to insulin is not yet standard for people with type 1 diabetes (PwT1D) but is being explored. Methods: T1DX-QI Collaborative administered a Qualtrics survey to providers at 55 centers Jul.-Sept. 2023 to determine current opinions and practices regarding the use of GLP-1a in PwT1D. Descriptive analysis was performed. Results: Fifty of 55 centers (91%) completed the survey. Fifty percent of pediatric and 75% of adult centers reported that GLP-1a have a role in T1D management as an adjunctive therapy to insulin. Both pediatric and adult centers reported that they would consider adding a GLP-1a to insulin therapy in PwT1D, based on BMI and total daily insulin dose. Adult providers were more likely to consider the PwT1D's desire to lose weight, personal or family history of early ASCVD, and presence of NAFLD compared with pediatric providers (Fig. 1). Both adult and pediatric centers reported insurance coverage as a barrier even when PwT1D meet criteria for GLP-1a treatment for weight loss based on BMI. Conclusions: A large percentage of centers report that GLP-1a have a role in T1D management. Providers consider a range of factors when adding GLP-1a to insulin therapy in PwT1D, including data that BMI is an independent risk factor for early ASCVD in PwT1D.