The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study
Abstract Background Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), a class of injectable antidiabetic drugs, have shown significant efficacies in improving glycemic and weight control in patients with type 2 diabetes (T2D). However, the long‐term safety of GLP‐1 RAs remains insufficiently st...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-10-01
|
| Series: | Journal of Diabetes |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1753-0407.70013 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850059728711843840 |
|---|---|
| author | Zhiyuan Cheng Shuang Wang Fu‐rong Li Cheng Jin Chunbao Mo Jing Zheng Xia Li Fengchao Liang Jinkui Yang Dongfeng Gu |
| author_facet | Zhiyuan Cheng Shuang Wang Fu‐rong Li Cheng Jin Chunbao Mo Jing Zheng Xia Li Fengchao Liang Jinkui Yang Dongfeng Gu |
| author_sort | Zhiyuan Cheng |
| collection | DOAJ |
| description | Abstract Background Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), a class of injectable antidiabetic drugs, have shown significant efficacies in improving glycemic and weight control in patients with type 2 diabetes (T2D). However, the long‐term safety of GLP‐1 RAs remains insufficiently studied. This study aimed to provide real‐world evidence on potential adverse outcomes associated with GLP‐1 RAs use in T2D patients without major chronic diseases including impaired cardiac or renal function. Methods We conducted a retrospective cohort study involving 7746 T2D patients on GLP‐1 RAs in Shenzhen, China. They were compared with 124 371 metformin‐only users and 36 146 insulin‐only users, forming two therapy control groups. GLP‐1 RAs users were also further 1:2 paired with the control groups. Competing risk survival analyses were conducted to assess the incidence risks, presenting subdistributional hazard ratios (sHRs) with 95% confidence intervals (CIs) for various adverse outcomes associated with GLP‐1 RAs use. Results Compared with metformin‐only users, GLP‐1 RAs use was associated with increased risks of various adverse outcomes (sHRs with 95% CIs), including pancreatitis (2.01, 1.24–3.24), acute nephritis (3.20, 2.17–4.70), kidney failure (3.73, 2.74–5.08), thyroid cancer (2.25, 1.23–4.10), and thyroid dysfunction (1.27, 1.00–1.63), respectively; Similar results were also found when compared with insulin‐only users. Importantly, long‐term (≥12 months) GLP‐1 RAs use may further elevate the incidence risks of pancreatitis, acute nephritis, thyroid cancer, and thyroid dysfunction. Conclusion Compared with traditional T2D treatments, GLP‐1 RAs use may be associated with increased risks of various adverse outcomes in a Chinese population. Cautions were strongly warranted in the use of GLP‐1 RAs. Further validation is crucial across diverse populations. |
| format | Article |
| id | doaj-art-bb757573ac26405dbf27de4cef7c0d18 |
| institution | DOAJ |
| issn | 1753-0393 1753-0407 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes |
| spelling | doaj-art-bb757573ac26405dbf27de4cef7c0d182025-08-20T02:50:48ZengWileyJournal of Diabetes1753-03931753-04072024-10-011610n/an/a10.1111/1753-0407.70013The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based studyZhiyuan Cheng0Shuang Wang1Fu‐rong Li2Cheng Jin3Chunbao Mo4Jing Zheng5Xia Li6Fengchao Liang7Jinkui Yang8Dongfeng Gu9School of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaShenzhen Health Development Research and Data Management Center Shenzhen ChinaSchool of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaSchool of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaSchool of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaShenzhen Health Development Research and Data Management Center Shenzhen ChinaSchool of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaSchool of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaDepartment of Endocrinology, Beijing Tongren Hospital Capital Medical University Beijing ChinaSchool of Public Health and Emergency Management Southern University of Science and Technology Shenzhen ChinaAbstract Background Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), a class of injectable antidiabetic drugs, have shown significant efficacies in improving glycemic and weight control in patients with type 2 diabetes (T2D). However, the long‐term safety of GLP‐1 RAs remains insufficiently studied. This study aimed to provide real‐world evidence on potential adverse outcomes associated with GLP‐1 RAs use in T2D patients without major chronic diseases including impaired cardiac or renal function. Methods We conducted a retrospective cohort study involving 7746 T2D patients on GLP‐1 RAs in Shenzhen, China. They were compared with 124 371 metformin‐only users and 36 146 insulin‐only users, forming two therapy control groups. GLP‐1 RAs users were also further 1:2 paired with the control groups. Competing risk survival analyses were conducted to assess the incidence risks, presenting subdistributional hazard ratios (sHRs) with 95% confidence intervals (CIs) for various adverse outcomes associated with GLP‐1 RAs use. Results Compared with metformin‐only users, GLP‐1 RAs use was associated with increased risks of various adverse outcomes (sHRs with 95% CIs), including pancreatitis (2.01, 1.24–3.24), acute nephritis (3.20, 2.17–4.70), kidney failure (3.73, 2.74–5.08), thyroid cancer (2.25, 1.23–4.10), and thyroid dysfunction (1.27, 1.00–1.63), respectively; Similar results were also found when compared with insulin‐only users. Importantly, long‐term (≥12 months) GLP‐1 RAs use may further elevate the incidence risks of pancreatitis, acute nephritis, thyroid cancer, and thyroid dysfunction. Conclusion Compared with traditional T2D treatments, GLP‐1 RAs use may be associated with increased risks of various adverse outcomes in a Chinese population. Cautions were strongly warranted in the use of GLP‐1 RAs. Further validation is crucial across diverse populations.https://doi.org/10.1111/1753-0407.70013clinical adverse outcomesGLP‐1 receptor agoniststype 2 diabetes |
| spellingShingle | Zhiyuan Cheng Shuang Wang Fu‐rong Li Cheng Jin Chunbao Mo Jing Zheng Xia Li Fengchao Liang Jinkui Yang Dongfeng Gu The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study Journal of Diabetes clinical adverse outcomes GLP‐1 receptor agonists type 2 diabetes |
| title | The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study |
| title_full | The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study |
| title_fullStr | The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study |
| title_full_unstemmed | The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study |
| title_short | The potential adverse effects of hypodermic glucagon‐like peptide ‐1 receptor agonist on patients with type 2 diabetes: A population‐based study |
| title_sort | potential adverse effects of hypodermic glucagon like peptide 1 receptor agonist on patients with type 2 diabetes a population based study |
| topic | clinical adverse outcomes GLP‐1 receptor agonists type 2 diabetes |
| url | https://doi.org/10.1111/1753-0407.70013 |
| work_keys_str_mv | AT zhiyuancheng thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT shuangwang thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT furongli thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT chengjin thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT chunbaomo thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT jingzheng thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT xiali thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT fengchaoliang thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT jinkuiyang thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT dongfenggu thepotentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT zhiyuancheng potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT shuangwang potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT furongli potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT chengjin potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT chunbaomo potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT jingzheng potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT xiali potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT fengchaoliang potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT jinkuiyang potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy AT dongfenggu potentialadverseeffectsofhypodermicglucagonlikepeptide1receptoragonistonpatientswithtype2diabetesapopulationbasedstudy |