Long‐term delirium and survival outcomes in patients treated with GLP ‐1 receptor agonists versus metformin in type 2 diabetes: A population‐based cohort study

May 7, 2025Diabetes, obesity & metabolism

Long-term delirium and survival in type 2 diabetes patients treated with GLP-1 drugs versus metformin

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Abstract

In a cohort of 126,192 patients with type 2 diabetes, GLP-1 receptor agonists initially reduced delirium risk but later increased it after five years.

  • GLP-1 receptor agonists showed no overall reduction in delirium risk when compared to metformin (adjusted hazard ratio: 0.98).
  • A protective effect against delirium was observed with GLP-1 receptor agonists within the first five years of treatment (adjusted hazard ratio: 0.89).
  • Between five and ten years, GLP-1 receptor agonists were associated with a higher risk of delirium (adjusted hazard ratio: 1.15).
  • Subgroup analyses indicated lower delirium risk in middle-aged patients (40-79 years) and those with HbA1c levels below 7.5%.
  • Higher delirium risk was noted among Asian and Native Hawaiian/Pacific Islander populations, although these findings are limited due to small sample sizes.
  • Mortality risk was lower for GLP-1 receptor agonists in absolute terms (6.28% vs. 9.95%) but associated with a higher long-term hazard (adjusted hazard ratio: 1.16).

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