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Adults with prediabetes and obesity who took GLP-1 medications had a 31% lower risk of developing type 2 diabetes and a 41% lower risk of death compared to those taking metformin.
Metformin is an oral medication used primarily to treat type 2 diabetes, widely considered the first-line treatment, combined with lifestyle modifications. It is also sometimes prescribed to people with prediabetes to help prevent or delay progression.
The findings, from a large observational study, are expected to be presented at the American Heart Association’s 2026 Scientific Sessions this weekend in Chicago. They have not yet gone through the full peer review process.
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The study looked at the medical records of 256,492 adults with prediabetes and obesity, with an average age of 52 years.
About half the group received GLP-1 (glucagon-like peptide-1 receptor agonists) drugs – including semaglutide, tirzepatide, liraglutide and dulaglutide – and half received metformin.
Adults with prediabetes and obesity who took GLP-1 medications had a 31% lower risk of developing type 2 diabetes and a 41% lower risk of death compared to those taking metformin. (iStock)
Based on a three-year follow-up, in addition to lower risk of diabetes and all-cause mortality, GLP-1 medications were associated with 20% fewer strokes, 15% fewer heart attacks, and 25% fewer cases of heart failure.
“The risk of death from any cause, 41 percent, surprised me the most,” study author Vinicius de Sousa Barzon Serra, MD, a researcher in the department of cardiovascular medicine at the Mayo Clinic in Scottsdale, Arizona, told Fox News Digital.
About half the group received GLP-1 (glucagon-like peptide-1 receptor agonists) drugs – including semaglutide, tirzepatide, liraglutide and dulaglutide – and half received metformin. (iStock)
“I expected that GLP-1 drugs would do better than metformin on blood sugar and diabetes risk because they cause much greater weight loss. I was also struck that the benefit showed up in many outcomes, including heart attack, stroke, heart failure, and atrial fibrillation.”
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Nearly 40% of American adults have prediabetes, according to AHA statistics. This condition is characterized by blood sugar levels that are higher than normal but not yet high enough for a diagnosis of diabetes.
Each year, up to 10% of people with prediabetes will develop type 2 diabetes.
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“Most previous research on these drugs has focused on people who already have diabetes,” Serra noted. “Our study suggests that the prediabetes stage might be an important time to consider them, rather than waiting until they develop type 2 diabetes.”
Nearly 40% of American adults have prediabetes, according to AHA statistics. This condition is characterized by blood sugar levels that are higher than normal but not yet high enough for a diagnosis of diabetes. (iStock)
The study had certain limitations. Although the study linked GLP-1 medications to better health outcomes, it does not prove that the medications are responsible.
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The results are preliminary until published in a peer-reviewed journal, Serra noted.
“We compared patients based on their age, health status and other characteristics to make the groups comparable…even so, other differences between the groups may remain,” he said. “We also grouped GLP-1 drugs together, so we can’t say whether the drugs differ.”
Metformin is an oral medication used primarily to treat type 2 diabetes, widely considered the first-line treatment, combined with lifestyle modifications. It is also sometimes prescribed to people with prediabetes to help prevent or delay progression. (Scott Olson/Getty Images)
The study relied on patients’ electronic health records, which could contain missing or incorrect information. It’s also possible that factors not measured in the study, such as medication dosage and compliance, could have influenced the results, the researchers noted.
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People with prediabetes and obesity should discuss all of their options with their doctor and should not stop or change a medication on their own, Serra advised.
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“Metformin is a safe and inexpensive option with a long track record, and lifestyle changes such as a healthy diet, regular physical activity and weight management remain the basis of treatment,” he stressed on Fox News Digital.
“For some patients, a GLP-1 drug may be worth discussing, depending on their overall health, other medical conditions, cost and access. The decision should be made in consultation with their doctor.”
Gn Health
