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Kidney disease is common in people with type 1 diabetes (T1D). It can lead to serious health problems, including kidney failure that may need dialysis or a kidney transplant. It can also damage the heart and blood vessels, which may lead to heart failure or stroke. That's why treatments that prevent and treat kidney disease in T1D are very important. Semaglutide is a drug that can lower blood sugar and body weight and has been shown to protect the kidneys in people with type 2 diabetes. Researchers do not know if semaglutide has similar benefits for people with T1D. Because of this, the use of semaglutide in those with T1D, including in this study, is experimental. To find out if you can join the study, you will have a visit to make sure you healthy enough to participate. The study team will ask about your health and medications, perform a physical exam, and check your blood pressure and heart rate. You will provide urine samples to help researchers learn about your kidney health. If you decide to take part in the study, you will also be asked to wear a continuous glucose monitor for two to eight weeks. This will help researchers better understand your blood sugar levels before you begin the study drug. If you qualify, you will be randomly assigned (like flipping a coin) to receive either semaglutide or a placebo. A placebo looks like the study drug but does not contain any active drug. Neither you nor the study doctor can choose which group you are assigned to. Participants in both groups will wear a continuous glucose monitor and give themselves one injection of the study drug under the skin each week using a pen device at home, similar to how insulin is given. During the study, you will have regular blood and urine tests, physical exams, eye exams, and magnetic resonance imaging (MRI) scans of your kidneys. You will also complete questionnaires. The study includes 10 visits that take place either in person or by phone. The entire study will last about nine months. There is no cost to you for the study drug, scans, or study visits. You will receive a $25 gift card for each completed visit, for a total of $250. If you leave the study early or are withdrawn from the study, you will be paid only for the visits you complete.

Who can Participate

You may be able to join this study if you are 18 years or older, have been diagnosed with T1D for five or more years, have a BMI of 20 or higher, have no history of liver disease, and not be pregnant or planning to become pregnant during the study. The study team will review your health history and other eligibility in more detail to make sure you can join.

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