The acmopatide type 1 diabetes trial found weight loss and a modest improvement in blood sugar over 16 weeks. Participants kept using insulin. The findings add evidence for medicines used alongside insulin in adults who also have overweight or obesity. Roche had already said it would discontinue development, so the new paper does not announce an approaching launch.
What the acmopatide type 1 diabetes trial found
As of November 5, 2026, the day this article was written, the October 28 report in Diabetes Care gives the peer-reviewed results of a 111-person trial. It tested acmopatide, also called CT-868, against placebo, an inactive treatment, for 16 weeks.
The ClinicalTrials.gov record, NCT06062069, names Carmot Therapeutics as the sponsor. Carmot is part of Roche. Participants were adults with type 1 diabetes for at least a year. Their BMI, a measure of weight relative to height, was at least 27. That limited the study to people with overweight or obesity.
The main measurement was A1c, a blood test reflecting average blood sugar over roughly three months. Weight and insulin use were additional measurements.
| Measurement at 16 weeks | Acmopatide groups | Placebo group |
|---|---|---|
| Average weight change | 3.3%–6.7% decrease | 0.3% increase |
| Average A1c change | 0.4–0.6 percentage-point decrease | 0.3 percentage-point decrease |
The 4.1-mg group had an extra 0.3-percentage-point A1c reduction compared with placebo. The authors call that finding nominally significant: it met a statistical threshold without adjustment for multiple comparisons. The public analysis plan confirms that those adjustments were not planned.
The lower and higher doses did not show a clear A1c difference from placebo.
Acmopatide and tirzepatide are different molecules that target the same two gut-hormone signals, GLP-1 and GIP. Both are dual agonists, meaning they switch on the two hormones' docking points on cells. That shared mechanism explains the interest in tirzepatide, but it does not make the drugs interchangeable.
What this means for tirzepatide and semaglutide
The practical question is whether a related medicine can help with weight while insulin continues to do its essential job. Tirzepatide and semaglutide are not FDA-approved to treat type 1 diabetes, and neither replaces insulin.
This was a phase 2 trial, an early test of treatment effects and safety in people with the condition. It can guide further research without settling long-term care.
In type 1 diabetes, the immune system attacks the cells that make insulin. Insulin allows the body to use blood sugar for energy. An appetite-related medicine cannot simply take over that job.
The acmopatide paper also reports lower daily insulin use: 3.4%–14.9% greater reductions than placebo in the two higher-dose groups. Those figures describe a monitored trial. They are not percentages someone can apply to their own insulin plan.
A separate tirzepatide trial by Snaith and colleagues, Diabetes Care, 2026, enrolled just 24 adults and lasted 12 weeks. It provides evidence about tirzepatide itself. It was not a direct comparison with acmopatide, so the studies cannot rank the two medicines.
Semaglutide acts on GLP-1 alone. The guide to semaglutide for type 1 diabetes explains its separate evidence and guidance. Any prescription discussion still needs to account for the person's insulin treatment, eating patterns and glucose readings.
What the safety findings leave open
The acmopatide paper reported no diabetic ketoacidosis, or DKA: dangerous acid buildup caused by too little insulin. It also reported no severe hypoglycemia, meaning low blood sugar that requires another person's help. Reported side effects were mainly gastrointestinal, meaning stomach or gut problems.
That is reassuring within this study. It does not establish safety over years or rule out uncommon problems. A 16-week trial involving 111 people can miss risks that become clearer with longer follow-up.
The entry rules matter, too. The registry excluded people who had DKA or severe low blood sugar within the previous three months. Its findings cannot simply be extended to people with those recent complications.
Insulin management remains central when appetite and food intake change. Too much insulin can cause low blood sugar. Too little can allow the acid buildup that leads to DKA. The diabetes team's ongoing review matters beyond the first prescription.
What a compounded prescription means here
Acmopatide is investigational and is not FDA-approved. The FDA's medicine database records drug decisions; a new journal publication does not change that status.
Through Promise, tirzepatide and semaglutide are dispensed by a licensed U.S. compounding pharmacy as compounded medications. They are different from FDA-approved products: the formulations offered here are not FDA-approved.
As of November 5, 2026, the day this article was written, the FDA's compounding explanation, updated June 22, 2026, states that the agency does not review these preparations for safety, effectiveness or quality before marketing. Acmopatide's results do not establish outcomes for a pharmacy's tirzepatide or semaglutide preparation.
A licensed provider may still prescribe — that decision is between you and your doctor. At Promise, a licensed provider reviews every request, and not everyone qualifies. The prescriber sets the actual dose.
What to watch next
As of November 5, 2026, the day this article was written, Roche's July 23 presentation already states that acmopatide development would be discontinued as other type 1 programs were prioritized. Publication of the completed study does not reverse that announcement.
Roche's enicepatide program involves CT-388, a separate molecule. Its progress cannot be treated as progress for CT-868.
For people with type 1 diabetes, the useful next evidence is larger, longer studies of each specific medicine. Those studies need to show how weight, blood sugar, insulin needs and serious complications fit together over time. A promising weight result is only part of that answer.
