A new study published in BMJ Medicine reports on Mar. 19 that people with type 2 diabetes who continue using glucagon-like peptide-1 receptor agonists (GLP-1RAs) for longer periods may have a lower risk of major adverse cardiovascular events compared to those who interrupt or discontinue the therapy.
The findings are important because GLP-1RAs are increasingly used for their benefits, including weight loss and reduced cardiovascular risk, but many patients stop taking them due to side effects or costs. The study suggests that stopping or interrupting treatment could reduce these health benefits over time.
Researchers analyzed electronic health records from the US Department of Veterans Affairs, focusing on adults with type 2 diabetes who started either sulfonylureas or GLP-1RAs between 2017 and 2023. Participants were followed for up to three years. The study found that continuous use of GLP-1RAs was linked to the greatest reduction in risk for heart attack, stroke, and death compared to sulfonylurea users. Specifically, those who maintained GLP-1RA therapy for three years had the lowest incidence risk ratio (IRR) at 0.82, while those with interruptions or discontinuations saw higher IRRs closer to those seen in the comparator group.
Discontinuation rates were high: about one-quarter of GLP-1RA users stopped treatment during follow-up, and nearly as many experienced interruptions. Even short-term discontinuation—just half a year—was associated with increased cardiovascular risks compared to continued use. Longer gaps led to progressively higher risks.
The authors note that while their results support the importance of staying on GLP-1RA therapy for sustained heart protection, their observational design means they cannot prove causality. Additionally, since most participants were male veterans, the findings may not apply broadly to women or non-veteran populations.
These results suggest that persistence with GLP-1RA treatment could be key in maximizing its protective effects against serious heart problems among people with type 2 diabetes.
