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Reading the adjunct evidence the way a reviewer would The pivotal liraglutide trials, ADJUNCT ONE and TWO, showed HbA1c effects below the regulatory threshold alongside dose-related ketosis and symptomatic hypoglycaemia, and the FDA did not approve liraglutide for type 1 on efficacy and safety grounds.6 The newer story is the automated-insulin-delivery era: ADJUST-T1D paired weekly semaglutide with an AID system in 72 adults with type 1 and obesity, and a composite goal (time in range above 70%, time below range under 4%, and at least 5% weight loss) was met by 36% versus 0% on placebo, with no ketoacidosis.8 Tirzepatide in type 1 rests on a single-centre observational cohort of 26 with no control arm

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