by Elana Gotkine

For older adults with type 2 diabetes (T2D), use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) is not associated with a significantly increased risk for suicidal ideation and behaviors, according to a study published online July 16 in the Annals of Internal Medicine.

Huilin Tang, from the University of Florida College of Pharmacy in Gainesville, and colleagues examined the association between GLP-1 RAs versus sodium-glucose cotransporter 2 inhibitors (SGLT2is) or dipeptidyl peptidase 4 inhibitors (DPP4is) and the risk for suicidal ideation and behaviors among older adults with T2D in two target trial emulation studies using U.S. national Medicare administrative data from January 2017 to December 2020. In each pairwise comparison, new GLP-1 RA users were matched in a 1:1 ratio on propensity score to new users of SGLT2is or DPP4is.

Overall, 21,807 pairs of patients treated with a GLP-1 RA versus an SGLT2i and 21,402 pairs of patients treated with a GLP-1 RA versus a DPP4i were included in the analyses. The researchers found that the hazard ratios of suicidal ideation and behaviors were not significantly different for GLP-1 RAs versus SGLT2is (1.07; 95% confidence interval, 0.80 to 1.45) or for GLP-1 RAs versus DPP4is (0.94; 95% confidence interval, 0.71 to 1.24).

"Among Medicare beneficiaries with T2D, this study found no clear increased risk for suicidal ideation and behaviors with GLP-1 RAs, although estimates were imprecise and a modest adverse effect could not be ruled out," the authors write.

More information: Huilin Tang et al, Glucagon-Like Peptide-1 Receptor Agonists and Risk for Suicidal Ideation and Behaviors in U.S. Older Adults With Type 2 Diabetes, Annals of Internal Medicine (2024). DOI: 10.7326/M24-0329

Journal information: Annals of Internal Medicine 

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