Kidney Week

Abstract: TH-PO1208

Cardiovascular Risk Prediction Modelling with Semaglutide in Patients with Type 1 Diabetes

Session Information

• Late-Breaking Research Posters
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Nardone, Massimo, University Health Network, Toronto, Ontario, Canada

Massimo Nardone, PhD

• Pasqua, Melissa-Rosina, McGill University, Montreal, Quebec, Canada

Melissa-Rosina Pasqua, PhD, MD

• Tsoukas, Michael A., McGill University, Montreal, Quebec, Canada

Michael A. Tsoukas, MD

• Kugathasan, Luxcia, University Health Network, Toronto, Ontario, Canada

Luxcia Kugathasan

• Sridhar, Vikas, The University of British Columbia, Vancouver, British Columbia, Canada

Vikas Sridhar, MD

• Muskiet, Marcel, Universiteit Leiden, Leiden, ZH, Netherlands

Marcel Muskiet, MD, PhD

• Cherney, David, University Health Network, Toronto, Ontario, Canada

David Cherney, MD, PhD

• Haidar, Ahmad, McGill University, Montreal, Quebec, Canada

Ahmad Haidar, PhD

Background

Semaglutide, a glucagon-like peptide-1 receptor agonist, improves glycemia, lowers body weight, and reduces cardiovascular (CV) events in people with type 2 diabetes. In type 1 diabetes (T1D), semaglutide also reduces hyperglycemia and body weight, but its impact on CV outcomes remains unknown. Because no CV outcome trials exist in this population, validated risk prediction models can provide insights into potential CV effects. We therefore aimed to evaluate the effect of semaglutide on estimated 10-year CV risk in people with T1D, hypothesizing that semaglutide would lower predicted risk.

Methods

This was a secondary analysis of a double-blind, randomized, crossover trial (NCT05205928), evaluating weekly subcutaneous semaglutide (titrated up to 1.0mg weekly for 15 weeks) with automated insulin delivery in adults with T1D. Medical history, demographic, and biochemical data from 22 participants (46±13 yrs, 32.5±5.4 kg/m², 54% female) were used to estimate the 10-year risk of a first fatal and non-fatal CV event using two validated models: the Steno T1 Risk Engine (ST1RE) and the Scottish Diabetes Research Network (SDRN) risk model. Risk was calculated at baseline and after 15 weeks of treatment with semaglutide or placebo. The percentage change in CV risk from baseline for each intervention was assessed using a paired sample t-test.

Results

Median baseline 10-year CV risk was ~12% (SRE: 12.4% [8.5, 20.8], SDRN: 11.5% [4.3, 18.5]). Using the ST1RE model, the median change in CV risk from baseline was -17.0% [-23.2, -6.5] and -5.1% [-20.0, -1.3] for semaglutide and placebo, respectively (placebo-adjusted difference [PAD]: -4.1% [-9.5, -1.4]; P=0.07). Using the SDRN model, the median change in CV risk from baseline was -10.7% [-25.3, -0.8] and -9.5% [-20.5, -2.9], respectively (PAD: 0.4% [-7.6, 6.8]; P=0.78).

Conclusion

Semaglutide did not significantly reduce estimated 10-year CV risk in people with T1D and a low-to-moderate baseline risk. However, the reductions observed suggest a trend toward benefit, although the two prediction models yielded differences in effect magnitude. Analyses in larger datasets would help clarify the potential impact of semaglutide on CV risk in T1D.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025m7ss8e68