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News
A new study in the Annals of Internal Medicine finds that GLP-1 medications don't significantly outperform SGLT2 or DPP-4 inhibitors in helping diabetes patients stop basal insulin. But experts say the study's older, sicker VA population and lack of lifestyle intervention data don't tell the full story — and that GLP-1s, especially paired with diet and exercise, still hold real promise.
Many diabetes patients on GLP-1 medications hope the drugs can help them ditch insulin — but a new study published in the Annals of Internal Medicine suggests it's not that simple. Analyzing electronic health records from nearly 9,000 VA patients, researchers found no significant difference in basal insulin discontinuation rates between those taking GLP-1 agonists (semaglutide) versus SGLT2 or DPP-4 inhibitors. Only 17% of patients across all groups were able to stop insulin altogether.
Experts caution that the study's limitations are significant. The cohort skewed older (65+), had poorly controlled diabetes (A1c >9%), and was managed mostly in primary care settings — all factors that make insulin withdrawal harder. Tirzepatide, a more potent GLP-1, was also not studied, and lifestyle interventions like diet and exercise counseling weren't tracked.
Key Takeaways:
Why it matters: As GLP-1 use surges among diabetes patients, clinicians need clearer protocols for insulin deprescribing. This study highlights a critical gap — and a call to action for more targeted research.
