New real-world evidence from Europe indicates a sharp rise in prescribing GLP-1 receptor agonists to children and young adults with type 2 diabetes, with significant improvements in weight, blood sugar, and blood pressure outcomes, highlighting evolving paediatric treatment practices.
New research presented at the annual meeting of the European Association for the Study of Diabetes in Milan suggests that drugs in the GLP-1 receptor agonist class are being used more often in children and young adults with type 2 diabetes across Germany, Austria and Luxembourg, and that the medicines are linked with better weight, blood sugar and blood pressure outcomes in routine care.
The findings come as clinicians continue to weigh how quickly these newer treatments are entering paediatric practice. European regulators first approved GLP-1 receptor agonists for type 2 diabetes in children from the age of 10 in 2019. Later approvals expanded their use for obesity in older children and, more recently, in younger children with obesity as well. Yet there has been relatively little real-world evidence on how widely the drugs are prescribed outside trials, especially among adolescents and young adults who often have complex health needs.
According to Dr Marie Auzanneau of Ulm University, who led the work, the question matters because a substantial number of young people are living with severe obesity and related complications, including sleep apnoea, depression and type 2 diabetes. In the DPV registry, which tracks diabetes care across the three countries, the researchers analysed 1,878 patients aged 6 to 24 with type 2 diabetes between 2019 and 2025. They found that 388 had received a GLP-1 receptor agonist during that period, and use rose sharply over time, from 6.3% in 2019 to 27.2% in 2025.
The increase was seen across age groups. By 2025, the medicines had been prescribed to 14% of children aged 6 to under 12, 28% of those aged 12 to under 18 and 29% of young adults aged 18 to 24. Liraglutide was the most commonly used treatment. Auzanneau said the drugs still appear to be underused, pointing to their recent arrival in paediatric care, possible worries about side effects and potential insurance barriers as reasons uptake has not been faster.
The second part of the analysis looked at health outcomes among 240 patients whose treatment was documented over at least two clinic visits. The median treatment duration was 11 months, and the drugs were most often used alongside other therapies, particularly metformin. In this group, about 19% had overweight, 44% had obesity and 32% had extreme obesity at the start of treatment. The average BMI standard deviation score, a way of comparing weight in growing children with others of the same age, was in the obese range.
Overall, the results suggested measurable benefit. More than a third of patients reduced their BMI standard deviation score by at least 5%, and a quarter achieved a fall of 10% or more. Blood sugar control improved, and the share with hypertension fell from 60% to 52%. The researchers said those gains remained after accounting for age, sex, migration background and starting weight. Auzanneau said the changes were meaningful because many of the young people had continued gaining weight for years despite lifestyle efforts.
The findings are broadly consistent with earlier trial data. Recent meta-analyses of randomised studies in children and adolescents have found that GLP-1 receptor agonists can lower HbA1c, fasting glucose, body weight, BMI and systolic blood pressure, although stomach and bowel side effects are more common. Those reviews did not show clear differences versus placebo in discontinuation rates, depression, suicidal thoughts or hepatobiliary problems. Separate trial evidence also supports the class, including a study of tirzepatide, a dual GIP/GLP-1 drug, in adolescents with inadequately controlled type 2 diabetes. Taken together, the new registry data suggest that the benefits seen in trials are beginning to translate into everyday paediatric diabetes care.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
