Real-world findings suggest GLP-1 drugs offer health benefits for young people with diabetes

by European Association for the Study of Diabetes

edited by Sadie Harley, reviewed by Robert Egan

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New research presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy, from Sept. 28–Oct. 2 examined the real-world use of GLP-1 receptor agonist (GLP-1 RA) drugs in children and young people in Germany, Austria and Luxembourg.

European regulators approved GLP-1 RAs to treat type 2 diabetes (T2D) in children starting at age 10 in 2019. Approval for weight management in children with obesity ages 12 and older followed in 2021, and the indication has since been extended to include children age 6 and older.

However, little is known about how the drugs, which include semaglutide (trade names Ozempic and Wegovy), liraglutide (brand names Victoza and Saxenda), dulaglutide (Trulicity) and tirzepatide (Mounjaro), are used in this population.

Dr. Marie Auzanneau of Ulm University in Germany, who led the research, says, "Around 200,000 young people in Germany are living with extreme obesity and they are often affected by severe obesity-related complications such as sleep apnea, depression and type 2 diabetes.

"GLP-1 receptor agonists specifically target the biological mechanisms of extreme obesity and can be particularly beneficial for adolescents who previously had continuous and significant weight gain, despite lifestyle interventions like diet and exercise programs.

"It is therefore important to know how often they are being prescribed."

To find out more, Auzanneau and colleagues in Germany, Austria and Luxembourg first looked at how use of these drugs has changed over time.

They analyzed information on all 1,878 people ages 6–24 with T2D (median age: 16.3 years, 54% female, 37% with a migration background) included between 2019 and 2025 in the Diabetes Prospective Follow-up (DPV) registry, a multicountry initiative designed to track the health of people with diabetes and improve their treatment.

They found that 388 of the 1,878 children and young people had taken GLP-1 RAs (including GIP/GLP-1 RAs, i.e., tirzepatide) during that time. Use rose from 6.3% of the 448 children and young people with T2D in the registry in 2019 to 27.2% of the 611 with T2D in 2025.

Use increased in all age groups. In 2025, the drugs were prescribed to 14% of children with T2D ages 6 to under 12, 28% of those ages 12 to under 18, and 29% of those ages 18–24.

"GLP-1 receptor agonists are probably still underused in children, adolescents and young people," says Auzanneau. "This is to be expected because these treatments are relatively new for these age groups. There may be concerns about side effects and there may be issues regarding health insurance coverage. We expect use to continue to increase as these issues are addressed."

Liraglutide was the most frequently prescribed. In 2025, it was used by 11.8% of all young people with T2D (n=611), corresponding to 72 of the 166 (43.4%) taking GLP-1 RAs that year.

The study's authors then looked at whether use of GLP-1 RAs was associated with changes in BMI, blood pressure and glycemic (blood sugar) control.

"We were interested in this because while these drugs have performed very well when given to young people under the tightly controlled conditions of clinical trials, data on concrete benefits in real-world conditions is lacking," explains Auzanneau.

This analysis focused on a subset of 240 children and young people (median age: 16.4 years, 59% female, 47% with a migration background) whose GLP-1 RA use was documented in the DPV database during at least two visits to the treatment center. GLP-1 RA treatment started at the first visit.

The median duration of GLP-1 RA use was 11 months. Liraglutide was the main GLP-1 RA used, followed by dulaglutide, semaglutide and tirzepatide (70%, 15%, 10% and 4%, respectively, at the first visit, and 63%, 17%, 17% and 8% at the last visit). GLP-1 RAs were typically used alongside other treatments, most commonly metformin.

Some 19% of the children and young people were living with overweight when they started GLP-1 RA therapy, 44% were living with obesity and 32% with extreme obesity.

Because children and teenagers are still growing, their BMI is expressed relative to others of the same age. One measure of this is BMI SDS, where a higher score indicates a higher weight. Average BMI SDS was 2.23, which is in the obese range.

More than a third (37%) of the young people achieved a reduction of ≥5% in their BMI SDS, and 25% achieved a reduction of at least 10%. The average reduction overall was 2.3%.

"A reduction of 2.3% is meaningful when we consider that many of these children and young people had gained weight for years, despite making lifestyle changes," says Auzanneau.

Glycemic control (measured via an HbA1c test) improved, and the proportion of children and young people with hypertension decreased from 60% to 52%.

Statistically significant reductions in BMI SDS and systolic blood pressure and improvements in glycemic control remained after adjustment for sex, age group, migration background and BMI at the start of therapy.

The study's authors conclude that real-world data from three European countries show that use of GLP-1 RAs is increasing rapidly in children, adolescents and young adults—with significant health benefits.

Auzanneau says, "Our results confirm that GLP-1 receptor agonists have real benefits for children, adolescents and young adults with type 2 diabetes—many of them have gained weight for years, despite making changes to their lifestyle.

"This isn't just about weight loss. By helping children, adolescents and young adults reach a healthier weight, these drugs should reduce their likelihood of developing depression, sleep apnea and other severe conditions that are linked to obesity.

"Moreover, by helping these young people achieve better glycemic control, the GLP-1 receptor agonists will help lower the risk of heart disease and damage to the eyes, kidneys and nerves. This is very important because these complications of type 2 diabetes reduce the quality and, often, also the length of life."

More information

Abstract 788: Use of GLP-1-RA in children, adolescents and young adults with type 2 diabetes: results from Germany, Austria, and Luxembourg based on the DPV registry, drive.google.com/file/d/1BOaAQ … FoufsYSQbqSR_39/view

Key medical concepts

GLP-1 Receptor Agonist [EPC]Diabetes Type 2Glycemic ControlSystolic blood pressure

Clinical categories

PediatricsEndocrinologyChildren's healthWeight managementClinical pharmacologyCommon illnesses & Prevention Provided by European Association for the Study of Diabetes Who's behind this story?

Sadie Harley

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