Association of GLP-1 receptor agonists with risk of intestinal obstruction in patients with type 2 diabetes mellitus: a retrospective cohort study.

BACKGROUND

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for treating type 2 diabetes and weight loss. There have been concerns that GLP-1RAs may increase the risk of intestinal obstruction.

OBJECTIVE

Investigate the association between GLP-1RAs use and intestinal obstruction in a large cohort of patients with type 2 diabetes mellitus (T2DM) in the U.S.

DESIGN

A retrospective cohort study was conducted using longitudinal electronic health records sourced from TriNetX, a large-scale, population-based health database.

PARTICIPANTS

The study included over 1.2 million T2DM patients who were prescribed anti-diabetic medications, including 181,795 prescribed GLP-1RAs between April 2013 and April 2019.

MAIN MEASURES

The incidence of intestinal obstruction was compared between GLP-1RAs and each of six other classes of non-GLP-1RA anti-diabetic medications. Hazard ratios (HRs) at 1, 3, and 5-year follow-up periods were calculated using Cox proportional hazards analysis. Separate analyses were performed in T2DM patients with and without obesity.

KEY RESULTS

The risk of intestinal obstruction did not differ between GLP-1RAs and other anti-diabetic medications except for a reduced risk compared with insulins. The results were consistent for 1, 3, and 5-year follow-up periods and in patients with and without obesity.

CONCLUSIONS

Our findings do not support an increased risk of intestinal obstruction in T2DM patients prescribed GLP-1 RAs compared to other anti-diabetic medications.