GLP-1 Medications May Help Turn Back Prediabetes, Study Finds

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CUTTING-EDGE weight-loss medicines such as Ozempic and Zepbound may help people reverse prediabetes and lower their risk of heart attack and stroke more effectively than standard diabetes drugs, according to a new study.

Adults with prediabetes had 53% better odds of returning their blood sugar to normal when they were using a GLP-1 drug instead of metformin, researchers are set to report at the annual meeting of the American Heart Association in Chicago.

They also appeared less likely to develop type 2 diabetes or experience serious heart complications while taking a GLP-1 medication, the researchers said.

“The great news with prediabetes is that it’s still possible to reverse the progression of the disease,” investigator Dr. Vinicius de Sousa Barzon Serra said in a news release. He is a research fellow in the department of cardiovascular medicine at the Mayo Clinic in Scottsdale, Arizona.

“This research may add to the case for considering GLP-1 medications earlier for certain patients, rather than waiting until they develop Type 2 diabetes,” he said.

Researchers said nearly 40% of Americans have prediabetes, a condition in which elevated blood sugar can lead to full-blown type 2 diabetes. Each year, up to 10% of people with prediabetes progress to type 2 diabetes.

For the study, the team reviewed medical records for more than 250,000 adults with prediabetes and obesity. Half were taking metformin, while the other half were prescribed a GLP-1 drug such as semaglutide, tirzepatide, liraglutide or dulaglutide.

The patients were treated at 104 hospitals over the period studied, and researchers followed them for about three years on average.

Overall, those taking GLP-1 medications were 53% more likely to reach normal blood sugar levels, had a 31% lower risk of developing type 2 diabetes and faced a 41% lower risk of death from any cause.

They also had 15% fewer heart attacks, 20% fewer strokes, 25% fewer cases of heart failure and 8% fewer cases of atrial fibrillation, an irregular heartbeat syndrome.

“The main effect these findings could have is on the shared decision-making discussion between doctors and patients exploring various treatment options, and the pros and cons for each,” Serra said.

“Metformin is still a first-line treatment choice. It is safe, inexpensive and has a long track record,” he said. “This is less about replacing one medication with another and more about discussing additional options with specific patients.”

Patients should not assume that GLP-1 drugs alone will do all the work needed to improve their health, Serra added.

“It’s important to note that an essential component of prediabetes treatment is lifestyle changes to manage weight, including diet and exercise and considering medications, including metformin, based on each individual’s overall health and any other medical conditions,” Serra said.

The benefits are likely tied to the weight loss caused by GLP-1 drugs, AHA spokesman Dr. Robert Eckel said in a news release.

Weight loss “is known to help prevent Type 2 diabetes,” said Eckel, a professor of medicine emeritus at the University of Colorado Anschutz Medical Campus who reviewed the findings. “Preventing the progression from pre-diabetes to Type 2 diabetes keeps patients from having Type 2 diabetes, and it also helps prevent heart attack and strokes.

“GLP-1s provide another option for prevention, perhaps as an add-on therapy,” he continued. “However, costs and access to these medications are important factors.”

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

SOURCE: American Heart Association, news release

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