[
For veterans with type 2 diabetes (T2D) receiving basal insulin therapy, the addition of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) does not increase the rate of insulin discontinuation compared with other glucose-lowering agents, according to a study published online July 14 in the Annals of Internal Medicine.
Kasia J. Lipska, MD, from the Yale School of Medicine in New Haven, Connecticut, and colleagues compared rates of insulin discontinuation among veterans with T2D receiving basal insulin who initiated treatment with a GLP-1 RA, sodium-glucose cotransporter 2 inhibitor (SGLT2i) or dipeptidyl peptidase-4 inhibitor (DPP-4i) between 2020 and 2022 in a target trial emulation. Data were included for 8,869 matched sets of GLP-1 RA, SGLT2i and DPP-4i initiators.
The researchers found that in the intention-to-treat analysis, 16.7%, 17.9% and 17.1% of GLP-1 RA, SGLT2i and DPP-4i initiators, respectively, discontinued insulin therapy over three years of follow-up (risk ratios, 0.93 [95% confidence interval, 0.86 to 1.01] and 0.98 [95% confidence interval, 0.87 to 1.09] for GLP-1 RA versus SGLT2i and DPP-4i, respectively). In a modified per-protocol analysis, results were not substantively different. With respect to insulin discontinuation, there was no comparative advantage for GLP-1 RAs over SGLT2is or DPP-4is in any subgroup.
“Although GLP-1 RAs remain valuable for their cardiovascular, renal and weight benefits, their initiation alone does not seem to drive basal insulin discontinuation beyond that observed with other glucose-lowering agents,” the authors write.
Publication details
Kasia J. Lipska et al, Comparative Effectiveness of Glucagon-like Peptide-1 Receptor Agonists Versus Oral Agents for Insulin Discontinuation in Type 2 Diabetes, Annals of Internal Medicine (2026). DOI: 10.7326/annals-25-05216
Journal information:
Annals of Internal Medicine
Clinical categories
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GLP-1 receptor agonist use does not increase insulin discontinuation with type 2 diabetes (2026, July 16)
retrieved 17 July 2026
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