Obesity Care

The Potential Risks of GLP-1s

Although GLP-1s have proven to significantly help with weight loss and cardiometabolic disorders, a new Nature Medicine study shed light on the drugs’ potential side-effects.

  • GLP-1s have skyrocketed in popularity due to their weight loss impact, while their potential heart benefits could make GLP-1s a common cardiology drug.
  • However, little is known about the long-term risks of this “wonder drug” class due to its relatively short time on the market and a lack of studies on the topic.

To tackle this problem, researchers compared Veteran’s Affairs data on 2 million T2D patients (2017-2023) taking either GLP-1s, DPP4is, SGLT2is, or usual care antihyperglycemics over a 3.68 year follow-up.

Starting with the good news, GLP-1s lowered risks for 42 health outcomes while increasing risks for 19 outcomes.

  • As expected, GLP-1s reduced MI risk by 9%, cardiac arrest by 22%, incident HF by 11%, ischemic stroke by 7%, and hemorrhagic stroke by 14%.
  • GLP-1s also led to an 8% lower risk of dementia and 12% lower risk of Alzheimer’s disease.

The less good news? There’s still no free lunch in healthcare.

  • The risk of GERD, gastritis, noninfectious gastroenteritis, gastroparesis, diverticulosis, and diverticulitis all increased with GLP-1s.
  • Other risks like hypotension, syncope, and nephritis also increased, as well as a 2.46X higher risk for drug-induced acute pancreatitis.

On the clinical side, these outcomes can help physicians make more personalized patient treatment decisions, as the researchers pointed out “people without diabetes and obesity likely wouldn’t experience many of these benefits.”

  • It’s also worth noting that the data came from military veterans who were older and mainly white, so the outcomes might not apply to other populations.

The Takeaway

Bearing in mind the current benefits of GLP-1s, it’s not likely that the side-effects examined by this study will slow down the pace of adoption. That said, it could serve as an early look into the long-term health outcomes of using GLP-1s to treat obesity and T2D.

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