Study links stopping GLP-1 diabetes drugs to higher heart attack, stroke and death risk

A study published in The Lancet Regional Health – Europe found that people with type 2 diabetes who stopped taking GLP-1 medications had about twice the risk of a non-fatal heart attack, non-fatal stroke or death from any cause compared with those who continued treatment.

Study findings

The study analyzed health records of 80,302 people with type 2 diabetes who received care at 301 diabetes clinics across Italy between 2004 and 2024. After propensity score matching, researchers compared two groups of 28,713 people each.

The incidence of the combined cardiovascular and mortality outcome was 3.94 events per 100 person-years among those who discontinued treatment, compared with 1.96 events per 100 person-years among those who continued. This translated into a hazard ratio of 2.03.

For death from any cause, the incidence was 2.23 events per 100 person-years in the discontinuation group, compared with 0.48 events per 100 person-years among those who continued treatment. The hazard ratio was 4.81.

The association was more pronounced among people with obesity. The hazard ratio for the combined outcome was 2.27 among people with a body mass index of 30 or above, compared with 1.61 among those with a BMI below 30.

Limitations and expert comment

Researchers cautioned that the observational nature of the study does not establish that stopping GLP-1 medicines directly causes heart attacks, strokes or death. They could not determine why individual patients discontinued treatment or fully account for other underlying health conditions.

The authors said discontinuation “may represent a marker of higher underlying risk rather than a direct cause of adverse outcomes.”

Professor Naveed Sattar, an expert in cardiometabolic medicine from University of Glasgow, said: “The major limitation of these findings is that they are observational.” He added: “As such, these data should be interpreted as associations rather than evidence that stopping the medication directly causes higher cardiovascular or other health risks.”

The findings may not apply to people taking GLP-1 medicines exclusively for obesity without diabetes. The study primarily included people with type 2 diabetes and did not establish whether the association extends to other patients.

Why it matters

• GLP-1 receptor agonists are used to manage type 2 diabetes and obesity because they help improve blood glucose control, promote weight loss and reduce cardiovascular risk.
• Discontinuation is common in routine clinical practice, with previous studies reporting that 20–50% of patients stop therapy within the first year.
• The researchers suggested that continued treatment may be important for maintaining the cardiovascular and mortality benefits associated with GLP-1 receptor agonists, but further prospective studies are needed.

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Sources

• globalnews.ca: Stopping GLP-1 drugs could increase heart attack risk for some, study says - National | Globalnews.ca
• thesouthfirst.com: Stopping GLP-1 drugs linked to twice the risk of heart attack, stroke or death in people with diabetes
• thepharmacist.co.uk: Stopping weight-loss drugs associated with increased risk of heart attack and stroke, study finds - The Pharmacist
• bdnews24.com: Quitting GLP-1 diabetes drugs doubles risk of heart attack or death, study shows

This article was drafted with AI assistance and checked against the sources above. Company claims are reported as claims. Cover image is AI-generated.