ArticleMedical science monitor : international medical journal of experimental and clinical research2025
Glucagon-Like Peptide-1 Receptor Agonists Lead to Gastrointestinal Benefits in Patients with Type 2 Diabetes: A Real-World Study.
Article in Medical science monitor : international medical journal of experimental and clinical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND Glucagon-like peptide-1 receptor agonist (GLP1-RA) is a promising therapy for heart and kidney health in type 2 diabetes mellitus (T2DM). However, information on its GI benefits is limited. This study aimed to investigate the gastrointestinal (GI) outcomes of GLP1-RA use in patients with T2DM. MATERIAL AND METHODS This retrospective cohort study utilized the TriNetX Dataset with a new-user and active-comparator design. The study included 2 304 761 adult patients diagnosed with T2DM and an estimated glomerular filtration rate of ≥60 mL/min/1.73 m² from January 2019 to December 2022. To establish cohorts, we designated users of dipeptidyl peptidase-4 inhibitors (DPP4i) as the control group. Two cohorts were formed for analysis after propensity score matching by baseline characteristics, each comprising 127 216 patients - one using GLP1-RA and the other DPP4i. Cox proportional hazards regression models were used to evaluate GI outcomes over 4 years between groups. RESULTS After matching, the average age of the population was about 60 years, with approximately 55% male and 63% identifying as White people. GLP1-RA users demonstrated a lower risk of acute pancreatitis (hazard ratio [HR]: 0.90, 95% confidence interval [CI]: 0.83-0.97), liver failure (HR: 0.81, 95% CI: 0.75-0.88), peritonitis (HR: 0.85, 95% CI: 0.76-0.94), peptic ulcer (HR: 0.89, 95% CI: 0.84-0.94), and GI bleeding (HR: 0.95, 95% CI: 0.92-0.98) compared to DPP4i users, indicating significant GI-protective effects. Furthermore, the GI advantages of GLP14A over DPP4i were consistently observed across various propensity score matching models. CONCLUSIONS GLP1-RA treatment in T2DM has some GI advantages compared to DPP4, which should be considered when personalizing T2DM treatment.
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