Evidence map›Paper›PMID 41361010›Full record

ArticleJournal of neurology2025

Impact of GLP-1 receptor agonists on cranial nerve palsies in type 2 diabetes: a retrospective cohort study.

Ronak Bhatia, Huda Al-Bana, Khalid Mohamed, Chimezie Amaefuna, Stephanie Johnson, Banuja Munasinghe, Rawan Elkomi, Syed Fahad Gillani, Elizabeth Beyene, Mekdem Bisrat and 1 more

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Article in Journal of neurology, 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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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Ronak BhatiaHoward University College of Medicine, Washington, DC, USA.
Huda Al-BanaHoward University College of Medicine, Washington, DC, USA.
Khalid MohamedHoward University College of Medicine, Washington, DC, USA.
Chimezie AmaefunaHoward University College of Medicine, Washington, DC, USA.
Stephanie JohnsonHoward University College of Medicine, Washington, DC, USA.
Banuja MunasingheHoward University College of Medicine, Washington, DC, USA.
Rawan ElkomiDepartment of Internal Medicine, Howard University, Washington, DC, USA. rawan.elkomi@gmail.com.ORCID http://orcid.org/0000-0002-3707-544X
Syed Fahad GillaniDepartment of Internal Medicine, Howard University, Washington, DC, USA.
Elizabeth BeyeneDepartment of Internal Medicine, Howard University, Washington, DC, USA.
Mekdem BisratDepartment of Internal Medicine, Howard University, Washington, DC, USA.
Miriam MichaelDepartment of Internal Medicine, Howard University, Washington, DC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 (GLP-1) receptor agonists have emerged as key agents in managing type 2 diabetes mellitus (T2DM), with proven benefits in glycemic control, weight loss, and cardiovascular risk reduction. However, their neurologic safety profile remains underexplored.

objectiveTo evaluate the association between GLP-1 receptor agonist use and the incidence of cranial nerve (CN) palsies in patients with T2DM.

methodsThis retrospective cohort study utilized the TriNetX Global Collaborative Network, comprising de-identified records from 160 healthcare organizations. Patients with T2DM treated with GLP-1 receptor agonists were compared to propensity-score-matched T2DM controls who never received GLP-1 therapy. Exclusion criteria included prior CN palsy diagnoses, CNS malignancy, type 1 diabetes, and neurological comorbidities. Outcomes assessed over a 10-year period included third nerve palsy (H49.0), sixth nerve palsy (H49.2), and Bell's palsy (G51.0). Propensity score matching was applied for age, sex, hypertension, dyslipidemia, insulin exposure, metformin use, and SGL2 inhibitor use.

resultsAfter matching (n = 841,219 per group), GLP-1 users had a significantly reduced incidence of CN III palsy (RR: 0.86, 95% CI: 0.76-0.98) and Bell's palsy (RR: 0.92, 95% CI: 0.87-0.96), with p < 0.05 for both. CN VI palsy demonstrated a moderately elevated risk ratio (RR: 1.15, 95% CI: 1.03-1.28), but long-term hazard favored GLP-1 therapy (HR: 0.76, 95% CI: 0.68-0.84). Hazard ratios showed consistent protective ratios across all three outcomes, supported by Kaplan-Meier survival analysis (log-rank p < 0.001).

conclusionWhile absolute risks remain low, GLP-1 receptor agonist use was associated with a statistically significant decrease in cranial nerve palsies, demonstrating a potential protective pattern across multiple cranial nerve palsies. These findings suggest possible neuroprotective or microvascular benefits of GLP-1 signaling and warrant further investigation, particularly in ophthalmological and neurological domains.

Indexed as

Cranial Nerve DiseasesDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsAgedCohort StudiesFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsBell’s palsyCranial nerve palsyGLP-1 receptor agonistsType 2 diabetes mellitus

Identifiers

PMID41361010

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.