People with type 2 diabetes who stop taking GLP-1 medicines may face twice the risk of a heart attack, stroke or death compared with those who continue treatment, according to a new study published in The Lancet Regional Health Europe.
The research found that patients who discontinued the drugs experienced around four combined cardiovascular events per 100 people each year, compared with approximately two events per 100 among those who remained on treatment.
GLP-1 medicines mimic a naturally occurring hormone that helps regulate blood sugar and appetite. Originally developed to treat type 2 diabetes, they have become widely used in managing obesity and have also demonstrated benefits for heart and kidney health.
Despite their effectiveness, many patients stop taking the medicines, often within the first year. Common reasons include gastrointestinal side effects, high treatment costs, concerns about potential complications and dissatisfaction with the results.
Discontinuing treatment is frequently followed by weight regain and deterioration in health indicators such as blood sugar and blood pressure.
The latest study found that the increased cardiovascular risk after stopping treatment was particularly pronounced among people with obesity. Patients with a body mass index above 30 experienced a 127 per cent higher cardiovascular risk, compared with a 61 per cent increase among those without obesity.
However, the researchers cautioned that their findings do not establish that stopping GLP-1 treatment directly causes heart attacks, strokes or deaths. Because the research was observational, other differences in patients’ health could have contributed to the results.
Study examined more than 80,000 patients
Researchers analysed electronic medical records from more than 300 diabetes clinics included in the Italian Association of Clinical Diabetologists database.
The study covered more than 80,000 people with type 2 diabetes who had started GLP-1 treatment between 2004 and 2024. None had a previously established cardiovascular disease at the beginning of the research period.
Most participants received earlier generations of GLP-1 medicines. Semaglutide, one of the more widely used newer treatments, accounted for only a small proportion of prescriptions. Tirzepatide was excluded because it entered the Italian market after the study period.
Patients who continued treatment remained on the medicines for an average of nearly three years, compared with just over one year among those who stopped.
The researchers also examined changes in weight, blood sugar and blood pressure following discontinuation. These measures changed only slightly, with no significant differences between patients who subsequently experienced a cardiovascular event and those who did not.
The findings suggest that changes in these conventional risk factors may not fully explain the higher rate of heart attacks, strokes and deaths among patients who stopped treatment.
The authors said sustained use of GLP-1 medicines could be important for maintaining health benefits in people with type 2 diabetes who have no established cardiovascular disease.
They stressed that further research is needed to establish whether discontinuing treatment contributes directly to increased cardiovascular risk or reflects underlying health problems that may already place patients at greater risk.
