A recent Yale-led study suggests that GLP-1 receptor agonists do not significantly increase the likelihood of insulin cessation among type 2 diabetes patients compared to other common medications, raising questions about their role in insulin withdrawal strategies.
A Yale-led study has found that GLP-1 drugs, which have become one of the most closely watched classes in diabetes care, did not help people with type 2 diabetes stop using insulin more often than two other common medication groups. The findings add nuance to the growing enthusiasm around GLP-1 receptor agonists, which have been shown in previous research to reduce insulin needs for some patients but have not yet been proven to help many come off insulin altogether.
Researchers at Yale School of Medicine analysed electronic health records from the U.S. Department of Veterans Affairs and matched 8,869 groups of veterans with type 2 diabetes who were already taking basal insulin and had started treatment with either a GLP-1 receptor agonist, an SGLT-2 inhibitor or a DPP-4 inhibitor. The study followed patients for three years and defined insulin discontinuation as a gap of at least 12 months between prescription refills. Most patients in the GLP-1 group were taking semaglutide, dulaglutide or liraglutide.
Over the study period, 16.7% of people starting a GLP-1 drug stopped insulin, compared with 17.9% of those on an SGLT-2 inhibitor and 17.1% of those on a DPP-4 inhibitor. In other words, the Yale team found no clear advantage for GLP-1 medicines in helping patients discontinue insulin. Kasia Lipska, a Yale researcher, said in a news release that the issue is “very complex” because patients often change medicines over time, making it difficult to isolate the effect of any single treatment.
The study’s authors said the results should not be taken to mean GLP-1 drugs have no role in reducing insulin use, only that adding one does not automatically make insulin withdrawal more likely than using the other medicines studied. They also pointed to important limits: the research was observational rather than a randomised trial, treatment plans changed over time, and participants did not necessarily reach the higher GLP-1 doses now available. Yale has separately reported that researchers are still examining broader questions about GLP-1 drugs, including their effects beyond blood sugar control, which reinforces how much remains unknown about when these medicines should be started, adjusted and, crucially, stopped.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
