Treatment with acmopatide (CT-868), a dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonist (GLP-1/GIP RA), improved glycemic management while reducing weight, insulin dose, and blood pressure in a phase 2 clinical trial of adults living with type 1 diabetes and obesity.

“We demonstrated that acmopatide 4.1 mg significantly improved glycemic control with an A1C reduction of about 0.34% compared to placebo, which was statistically significant, and without reaching a plateau,” said Klara Klein, MD, PhD, Assistant Professor of Endocrinology and Metabolism and Director of the Endocrine Diabetes and Obesity Clinical Research Unit at the University of North Carolina at Chapel Hill.

These findings were shared on Friday, June 5 during the symposium, Dual Agonism in Type 1 Diabetes: Unveiling Efficacy and Safety of Adjunct Therapy with CT-868 (GLP-1/GIP RA) in Adults with Type 1 Diabetes—Phase 1 and 2 Results, at the 2026 Scientific Sessions. On-demand access to recorded presentations will be available to registered participants following the conclusion of the meeting, from June 10–August 10.

The phase 2, double-blind, randomized, and placebo-controlled study evaluated the efficacy and safety of acmopatide in adults with type 1 diabetes and overweight or obesity. Of the 111 patients enrolled, a quarter were randomized to receive acmopatide does of 1.8 mg, 4.1 mg, or 6.6 mg, or placebo for 16 weeks. The primary endpoint was the change in A1C from baseline to week 16.

Key secondary endpoints, outlined by Jeremy Pettus, MD, Associate Professor of Medicine at the University of California, San Diego, included the proportion of participants achieving the American Diabetes Association^® (ADA)-recommended A1C target, percent change in body weight, and percent change in total daily insulin dose.

A total of 56% and 44% of adults randomized to acmopatide does of 4.1 mg and 6.6 mg, respectively, achieved the ADA-recommended A1C target of less than 7%, compared with 33% in the placebo group. Treatment with acmopatide showed a dose-dependent reduction in body weight, with decreases reaching up to 6.67%. Additionally, reductions in daily insulin doses were observed in both the 4.1 mg and 6.6 mg acmopatide groups, with the higher-dose group experiencing up to a 15% decrease. In terms of safety, there was no evidence of diabetic ketoacidosis or severe hypoglycemia with acmopatide.

Results from a phase 1 trial of acmopatide were also presented at this symposium by Richard E. Pratley, MD, the Samuel Crockett Chair in Diabetes Research, Medical Director at AdventHealth Diabetes Institute, Senior Scientist and Diabetes Program Head, Advent Health Translational Research Institute, and Adjunct Professor at Johns Hopkins School of Medicine. 

“This mechanistic proof of concept study showed that acmopatide, administered at high daily loading doses, showed a very attenuated postprandial glucose response during this mixed meal tolerance test that was accompanied by suppression of glucagon as well as delayed gastric emptying. It was also associated with lower basal insulin requirements and decreased interest in food and actual food intake,” Dr. Pratley said.

Despite positive phase 1 and phase 2 results, the manufacturer has decided not to advance development of acmopatide into phase 3 clinical trials.

Even so, Dr. Pettus said a pathway to future access to safe and effective GLP-1-based therapies for type 1 diabetes still exists.

“I think what is clear now is that these drugs work in type 1 diabetes. [We have presented] another phase 2 study that showed positive benefits. People like it, and it’s generally safe in people with type 1 diabetes. We confirmed that, and now it’s about getting a drug approved in this space,” he said.  

Obtaining approval for a GLP-1-based therapy for type 1 diabetes may require a different drug titration approach than in type 2 diabetes, Dr. Pettus noted. Additionally, he said efforts should focus on clinician education, patient awareness, and establishing realistic expectations.

Although metabolic therapies are effective in type 2 diabetes, they have not yet been widely adopted for type 1 diabetes. Changing this approach will take time, Dr. Pettus emphasized. To begin addressing this, he said there needs to be a shift in perspective on type 1 diabetes and type 2 diabetes, recognizing that patients with type 1 diabetes can also live with obesity. Additionally, he said caution is necessary when comparing results of GLP-1-based medications in type 1 diabetes and type 2 diabetes. For instance, many who use these therapies to treat type 2 diabetes may have become accustomed to larger A1C changes, which may not apply to people living with type 1 diabetes because of insulin use.

Register On-site for the 2026 Scientific Sessions

You can register on-site at the Ernest N. Morial Convention Center in New Orleans to join the 2026 Scientific Sessions, taking place June 5–8. Don’t miss your chance to learn about the latest advances in diabetes research, prevention, and care. After the meeting, registered participants will have on-demand access to recorded presentations.