Comparative outcomes of systemic diseases in people with type 2 diabetes, or obesity alone treated with and without GLP-1 receptor agonists: a retrospective cohort study from the Global Collaborative Network

Sep 20, 2024Journal of endocrinological investigation

Health outcomes in people with type 2 diabetes or obesity treated with or without GLP-1 receptor medicines

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Abstract

GLP-1 receptor agonist treatment is associated with significantly lower incidences of dementia, Alzheimer's disease, Parkinson's disease, and pancreatic cancer in individuals with type 2 diabetes.

In the type 2 diabetes cohort, treatment with GLP-1 receptor agonists resulted in a risk difference of -0.010 for dementia, indicating a notable reduction.
Alzheimer's disease and Parkinson's disease incidences were also lower among those receiving GLP-1RAs, with risk differences of -0.003 and -0.002, respectively.
Statistically significant reductions were observed for systemic lupus erythematosus and systemic sclerosis, although the risk differences were minimal at -0.001 and -0.000, respectively.
Conversely, bronchial asthma risk slightly increased with GLP-1RA treatment, showing a risk difference of 0.002.

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BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used to manage type 2 diabetes (T2D) and obesity. Despite their recognized benefits in glycemic control and weight management, their impact on broader systemic has been less explored.

OBJECTIVE: This study aimed to evaluate the impact of GLP-1RAs on a variety of systemic diseases in people with T2D or obesity.

METHODS: We conducted a retrospective cohort study using data from the Global Collaborative Network, accessed through the TriNetX analytics platform. The study comprised two primary groups: individuals with T2D and those with obesity. Each group was further divided into subgroups based on whether they received GLP-1RA treatment or not. Data were analyzed over more than a 5-year follow-up period, comparing incidences of systemic diseases; systemic lupus erythematosus (SLE), systemic sclerosis (SS), rheumatoid arthritis (RA), ulcerative colitis (UC), crohn's disease (CD), alzheimer's disease (AD), parkinson's disease (PD), dementia, bronchial asthma (BA), osteoporosis, and several cancers.

RESULTS: In the T2D cohorts, GLP-1RA treatment was associated with significantly lower incidences of several systemic and metabolic conditions as compared to those without GLP-1RA, specifically, dementia (Risk Difference (RD): -0.010, p < 0.001), AD (RD: -0.003, p < 0.001), PD (RD: -0.002, p < 0.001), and pancreatic cancer (RD: -0.003, p < 0.001). SLE and SS also saw statistically significant reductions, though the differences were minor in magnitude (RD: -0.001 and - 0.000 respectively, p < 0.001 for both). Conversely, BA a showed a slight increase in risk (RD: 0.002, p < 0.001).

CONCLUSIONS: GLP-1RAs demonstrate potential benefits in reducing the risk of several systemic conditions in people with T2D or obesity. Further prospective studies are needed to confirm these effects fully and understand the mechanisms.

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Comparative outcomes of systemic diseases in people with type 2 diabetes, or obesity alone treated with and without GLP-1 receptor agonists: a retrospective cohort study from the Global Collaborative Network

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