Study links discontinuation of GLP-1 drugs to higher cardiovascular risk in type 2 diabetes

An observational study published in The Lancet Regional Health – Europe examined electronic medical records from more than 300 diabetes clinics in Italy. Researchers identified over 80,000 patients with type 2 diabetes who had been prescribed GLP-1 medications such as semaglutide. About half of these patients discontinued treatment within the first year.

Patients who continued GLP-1 therapy for an average of nearly three years experienced roughly half the rate of non-fatal heart attack, non-fatal stroke or death compared with those who stopped after about one year. The authors estimated the incidence at four events per 100 people per year among discontinuers versus two per 100 among continuers. The increased risk appeared greater in patients who remained obese, and it was observed regardless of changes in weight, blood sugar or blood pressure.

The researchers emphasized that the study’s observational design cannot establish a causal relationship; it is unclear whether stopping the medication directly raised risk or whether patients who stopped were already in poorer health. Reasons for discontinuation were not recorded and could include side effects, cost or other illness. The analysis also excluded tirzepatide, the active ingredient in Mounjaro, so the findings do not apply to that drug.

"We know that GLP-1 medication can help protect against heart attacks and strokes. This study found that people with type 2 diabetes who stopped taking GLP-1s had a higher risk of heart problems compared to those who continued treatment," said Dr. Faye Riley, research communications lead at Diabetes UK.

"However, these findings should be interpreted with caution. This was an observational study, so we can’t tell whether stopping taking GLP-1s directly raised people’s risk of heart attack and stroke, or if those who discontinued treatment were already experiencing health problems. The findings reinforce the importance of supporting people to stay on treatments that work for them," Riley added.