Stopping GLP-1 Therapy Doubles Cardiovascular Risk in Diabetes

Stopping GLP-1 medicines, which are widely prescribed to manage type 2 diabetes as well as obesity, was linked in a new observational study to a roughly two-fold increase in the combined risk of non-fatal myocardial infarction, non-fatal stroke, or death when compared with patients who continued the therapy.

The research was published in The Lancet Regional Health Europe. It estimated four adverse events per 100 patients each year after discontinuation. About two events per 100 were observed among those on medication.

Risk elevation differed according to body-mass index. Individuals with obesity (BMI > 30) faced a 127% higher cardiovascular risk after stopping, while the increase measured for non-obese participants was 61%.

Because the investigation relied on observational data, it cannot definitively confirm that stopping the drugs caused the higher risk; the possibility remains that the people who discontinued were already experiencing poorer health or other confounding conditions.

Earlier work on other glucose-lowering treatments has shown similar patterns when therapy is interrupted, suggesting that maintaining medication continuity may be essential for protecting the cardiovascular system.

Researchers examined electronic medical records from more than 300 diabetes clinics that belong to the Italian Association of Clinical Diabetologists database, covering a cohort of over 80,000 type 2 diabetes patients who had no prior cardiovascular disease and who initiated a GLP-1 agent between 2004 and 2024.

The majority of the cohort used first-generation GLP-1 agents; newer drugs such as semaglutide represented only a small share, and tirzepatide was absent because it entered the Italian market after the study period had ended.

Patients who remained on treatment used a GLP-1 for an average of nearly three years, whereas those who stopped did so after just over one year of exposure.

The authors concluded that long-term GLP-1 use might be important for preserving overall health benefits in type 2 diabetes patients lacking established cardiovascular disease, and they called for further research to clarify whether discontinuation directly raises risk or merely signals underlying health decline.

Overall, the dataset comprised more than 80,000 individuals tracked across the period from 2004 through 2024, providing a broad view of treatment patterns in Italy.