Diabetes Therapy最新文献

{"title":"Morbidity and Mortality Rates in People with Diabetes Mellitus With an Active Charcot's Neuro-Osteoarthropathy: A 15-Year Single-Center Retrospective Analysis.","authors":"Dipen Patel, Catherine Gooday, Ian Nunney, Ketan Dhatariya","doi":"10.1007/s13300-026-01874-4","DOIUrl":"10.1007/s13300-026-01874-4","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes related Charcot neuro-osteoarthropathy (CN) of the foot is associated with increased risks of amputation and premature mortality. We aimed to report the amputation and mortality rates of people with active CN and identify participant and CN characteristics associated with these adverse outcomes.</p><p><strong>Methods: </strong>A single-center retrospective study. Participants were included if they were diagnosed with an active CN with type 1 or type 2 diabetes mellitus presenting to a specialist foot clinic between January 2007 and September 2022. Participant and CN characteristics were analyzed to determine relationships with amputation or mortality.</p><p><strong>Results: </strong>186 participants were included with 195 CN feet. Median follow-up was 8.2 years (IQR 5.3, 12.2). Male sex (p = 0.026) and previous amputation (p = 0.003) were associated with a significantly increased risk of amputation. The 1-year, 5-year, and 10-year mortality rates were 2.7% (5/186), 18.9% (23/122), and 40% (24/60), respectively. Previous amputation and worsening chronic kidney disease stage were associated with a significantly increased mortality risk (p = 0.005 and p = 0.027, respectively).</p><p><strong>Conclusions: </strong>Participants with CN had high amputation and mortality rates. The causes of death were multifactorial, suggesting clinicians should focus on early aggressive multiple risk factor intervention to reduce these adverse outcomes.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"985-996"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological and Social Risk Factors for Predicting Type 2 Diabetes in Youth with Prediabetes: Review of Existing Prediction Models.","authors":"Subin Jang, Sisi Ma, Daniel S Hsia, Kristina Cossen, David Haynes, Megan O Bensignor","doi":"10.1007/s13300-026-01873-5","DOIUrl":"10.1007/s13300-026-01873-5","url":null,"abstract":"<p><p>With the rising prevalence of type 2 diabetes (T2D) among children and adolescents, the ability to predict the progression of prediabetes to T2D in youth is imperative, as it significantly affects long-term health and quality of life. A number of biological and social risk factors have been identified in literature. Additionally, a growing body of literature illustrates the use of machine learning techniques to identify those with prediabetes or T2D in adults. A prediction model identifying adults with prediabetes who are most likely to progress to T2D has been suggested; however, to date, no such predictive algorithm in youth with prediabetes, a population with a high rate of spontaneous regression to normoglycemia, has been developed. Machine learning (ML) techniques can be applied to potentially identify novel risk factors for youth-onset T2D progression. The use of ML techniques with longitudinal data would enrich the prediction models to accurately identify children with prediabetes who are at the most risk of developing T2D without intervention. This narrative review summarizes the literature on biological and social risk factors for T2D progression and the use of ML to predict progression to T2D.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"911-919"},"PeriodicalIF":4.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide and Cardiovascular Outcomes in People with Type 2 Diabetes: A SUSTAIN-6 Post Hoc Analysis by Weight Loss Category.","authors":"Angelo Navas, Joshua Noone, Nathan Laney, Sunny Sheth, Xi Tan, Yuanjie Liang, Paloma Munoz, Caroline Swift","doi":"10.1007/s13300-026-01875-3","DOIUrl":"10.1007/s13300-026-01875-3","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes (T2D) is a known risk factor for cardiovascular (CV) disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as semaglutide, improve glycemic control and are associated with weight loss, but the impact of weight loss on major adverse cardiovascular events (MACE) when taking semaglutide is not fully understood. This post hoc analysis of the SUSTAIN-6 trial aimed to examine the correlation between weight loss with semaglutide and the occurrence of MACE (nonfatal myocardial infarction, nonfatal ischemic stroke, and CV death).</p><p><strong>Methods: </strong>This study is a single-arm, post hoc, observational analysis of the randomized, double-blind, placebo-controlled SUSTAIN-6 cardiovascular outcomes trial (NCT01720446). Participants in the semaglutide group (N = 1479) were stratified into four weight loss categories on the basis of the percentage change in body weight from baseline to 56 weeks: no loss/gain, < 5% loss, 5-10% loss, and > 10% loss. The occurrence of MACE during the follow-up period (weeks 56-104) was compared across weight loss categories using descriptive statistics and logistic regression adjusted for age and sex. Categorical variables were compared across groups using chi-squared tests, and continuous variables were compared using analysis of variance (ANOVA).</p><p><strong>Results: </strong>Point estimates of MACE incidence did not differ by weight loss category (P = 0.73). The MACE event rate was comparable across weight loss categories (no loss/gain: 1.05%; < 5% loss: 1.69%; loss 5-10%: 1.06%, > 10% loss: 0.89%). Compared with the no weight loss/gain category, no degree of weight loss was associated with lower adjusted odds (odds ratio) of MACE (loss < 5%: 1.68; P = 0.66; loss 5-10%: 1.13; P = 0.77; loss > 10%: 1.06; P = 0.95).</p><p><strong>Conclusions: </strong>This post hoc analysis of SUSTAIN-6 did not find an association between the magnitude of weight loss achieved after 56 weeks of semaglutide treatment and subsequent MACE risk in people with T2D, suggesting that weight-independent mechanisms may mediate the cardioprotective effects of semaglutide.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"897-910"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podcast Episode 2: Heart Failure Management in Patients with Diabetes for Endocrinologists, Primary Care Physicians, and Noncardiologist Clinicians: Focus on SGLT2 Inhibitors.","authors":"Nihar R Desai, Silvio E Inzucchi, Eugene E Wright","doi":"10.1007/s13300-026-01856-6","DOIUrl":"10.1007/s13300-026-01856-6","url":null,"abstract":"<p><p>Heart failure is a major complication of type 2 diabetes and patients with type 2 diabetes often have to manage multiple comorbid conditions that increase the risk of heart failure, such as hypertension, obesity, chronic kidney disease, and hyperlipidemia. Therefore, management of cardiovascular risk factors through lifestyle modifications and pharmacological intervention is fundamental to prevent the progression of heart failure in patients with diabetes. Hospitalization is common in patients with heart failure, and hospitalizations represent the largest component of direct medical costs for heart failure. Therapies that reduce the burden of hospitalization for heart failure are greatly needed. In this podcast series of three episodes, a cardiovascular specialist, an endocrinologist, and a primary care physician will provide practical guidance for primary care physicians on optimal identification and management of heart failure in patients with diabetes. In this second episode in the series, we give an overview of the tools available to clinicians to reduce the risk of heart failure progression in patients with early-stage heart failure. This includes the discussion of lifestyle modifications as well as the cardiovascular benefits of sodium-glucose co-transporter 2 inhibitors and other medications used at the intersection of diabetes and heart failure. Podcast available for this article.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"807-814"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology in Diabetes: A Year in Review.","authors":"Subhankar Chatterjee, Subhodip Pramanik, Nitin Kapoor, Sanjay Kalra","doi":"10.1007/s13300-026-01871-7","DOIUrl":"10.1007/s13300-026-01871-7","url":null,"abstract":"<p><p>The past year has continued the rapid evolution of diabetes technology across the monitoring, delivery, analytics, and patient-support domains. Improvements in continuous glucose monitoring (CGM) accuracy and wear-time options, widening use and regulatory expansion of automated insulin delivery (AID) systems, growth in connected insulin pens, maturation of digital therapeutics, and an influx of artificial intelligence (AI)-driven decision support tools have together shifted diabetes care toward tighter, more personalized, and more remote models of management. At the same time, device safety events, persistent affordability and access gaps, and data-interoperability and privacy challenges remind clinicians and policymakers that technology alone is not a panacea. This review summarizes the most important developments from last year (2025), highlights evidence from recent trials and regulatory actions, and discusses implications for practice and future directions.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"823-837"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life and Humanistic Burden of Adults with Type 1 Diabetes with Recurrent Severe Hypoglycemic Events and Impaired Awareness of Hypoglycemia Using a Continuous Glucose Monitor.","authors":"Adriana Boateng-Kuffour, Caitlin S Kelly, Huyen T Nguyen, Nanxin Li, Keval Chandarana, Katherine S Chapman, Liang Chen, Emilee M Cornelius, Wendy A Wolf, Beth Barber, William H Polonsky","doi":"10.1007/s13300-026-01869-1","DOIUrl":"10.1007/s13300-026-01869-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to examine psychosocial well-being, quality of life (QoL), and productivity in people with type 1 diabetes (pwT1D) who were experiencing recurrent severe hypoglycemic events (SHEs) and impaired awareness of hypoglycemia (IAH), despite using continuous glucose monitors (CGMs).</p><p><strong>Methods: </strong>The study utilized a cross-sectional, observational design which incorporated an online survey about SHE experiences, diabetes-related complications, psychosocial burden, QoL, and productivity in a sample of adult pwT1D who use CGM in the United States. Participants completed measures of IAH status (modified Gold score ≥ 4 = IAH), diabetes distress (DDS-17), fear of hypoglycemia (HFS-II), QoL (DIDP and EQ-5D-5L), and productivity (DPM). Participants were categorized into two cohorts based on self-reported history of SHEs and IAH: the cohort of recurrent SHE [≥ 2 SHEs in the past 12 months] with IAH, and the cohort of No SHE and No IAH to provide context. Unadjusted comparisons (Welch's t test, Pearson's chi-squared test) were conducted to describe differences across cohorts.</p><p><strong>Results: </strong>In this US study population of adult CGM users, the recurrent SHE (≥ 2) with IAH cohort included 174 participants, and the No SHE and No IAH cohort included 689 participants. On average, participants with recurrent SHEs and IAH reported 8.6 SHEs in the past year. Compared to those with No SHE and No IAH, those with recurrent SHEs and IAH had a higher psychosocial burden (fear of hypoglycemia and diabetes distress), lower QoL, worse overall health status, and reduced productivity (all p < 0.001).</p><p><strong>Conclusions: </strong>Despite using CGM, adults with T1D with recurrent SHEs and IAH experienced lower psychosocial well-being, QoL, and reduced productivity compared to adults with T1D with no SHEs and no IAH, highlighting the unmet need for novel therapies for this group.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"885-896"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistence-Dependent Effectiveness of Tirzepatide on the Cardio-Metabolic-Kidney Syndrome Outcomes in Obesity: Real-World Evidence from the United Arab Emirates.","authors":"Imran Rashid Rangraze, Mohamed El-Tanani, Andrej Janez, Viviana Maggio, Syed Arman Rabbani, Mojca Jensterle, Ana Munda, Elhadi Eltayeb Abbas, Humam Sami Ali, Mohammad Rashid Farooqi, Mohamed Anas Faruk Patni, Manfredi Rizzo","doi":"10.1007/s13300-026-01868-2","DOIUrl":"10.1007/s13300-026-01868-2","url":null,"abstract":"<p><strong>Introduction: </strong>Tirzepatide has been associated with significant reductions in body weight in randomized clinical trials. However, real-world evidence evaluating the multisystemic effects of tirzepatide across the cardio-metabolic-kidney (CKM) continuum remains limited. The aim of this study was to assess the real-world persistence-driven cumulative benefits of tirzepatide beyond weight reduction in adults with obesity but without type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>This single-center observational cohort study evaluated in the United Arab Emirates adults with obesity (body mass index [BMI] ≥ 30 kg/m²) treated with tirzepatide. Participants were stratified by treatment persistence: ≤ 1 year (short-term) and > 1 year (long-term). Anthropometric, glycemic, lipid, hepatic, and renal outcomes were assessed at baseline and follow-up.</p><p><strong>Results: </strong>One hundred participants (25 women; mean age 37.6 ± 10.0 years; baseline BMI 35.0 [33.0-39.0] kg/m²) were included. Median weight reduction was - 8.1% in the short-term group and - 22.6% in the long-term group (p < 0.001). 62% of long-term treated individuals achieved > 15% weight loss versus 20% among short-term users. Significant between-group differences were observed in BMI (- 8.3% vs. - 19.1%), waist circumference (- 4.0% vs. - 9.2%), and glycated hemoglobin (HbA1c) (- 5.0% vs. - 7.2%). Total cholesterol decreased by - 10.1% vs. - 18.7% (p = 0.005), low-density lipoprotein cholesterol (LDL-C) by - 9.6% vs. - 30.5% (p < 0.001), and triglycerides by - 11.2% vs. - 32.5% (p < 0.001). Liver enzymes, aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) declined by - 11.3% and - 13.2%, respectively, in long term group with no significant improvement in short term group (between-groups p values for both liver enzymes < 0.05). Serum creatinine declined significantly in the long-term group (- 6.6%, p < 0.001), estimated glomerular filtration rate (eGFR) increasing by + 3.2% (p = 0.001), and blood urea nitrogen (BUN) decreasing by - 7.8% (p = 0.006) while microalbuminuria showed no meaningful changes. Weight loss correlated with improvements in LDL-C, triglycerides, and SGOT, and inversely with high-density lipoprotein cholesterol (HDL-C) changes.</p><p><strong>Conclusions: </strong>Tirzepatide showed greater cumulative benefits across CKM syndrome outcomes during the second treatment year, highlighting the need to overcome adherence barriers in real-world settings.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"873-884"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podcast Episode 3: How Can Physicians Work Collaboratively to Improve Cardiovascular Outcomes in Patients with Type 2 Diabetes?","authors":"Nihar R Desai, Silvio E Inzucchi, Eugene E Wright","doi":"10.1007/s13300-026-01857-5","DOIUrl":"10.1007/s13300-026-01857-5","url":null,"abstract":"<p><p>Heart failure is a common and often underappreciated complication of type 2 diabetes. Patients with type 2 diabetes frequently have multiple interconnected comorbidities, including hypertension, chronic kidney disease, and obesity, which can culminate in cardiovascular-kidney-metabolic syndrome. Effective management of cardiovascular complications in patients with type 2 diabetes requires a comprehensive, coordinated approach to optimize treatment plans and improve overall patient care. Collaborative care models, involving multidisciplinary teams, can significantly improve patient outcomes by enhancing medication adherence, reducing hospitalizations, and preventing the progression of heart failure. This approach provides holistic care to patients and reduces risk from multiple directions. Costs and insurance coverage issues can limit access to collaborative care; however, digital health interventions, virtual collaboration, and community support can help to overcome these barriers for primary care physicians and patients, especially in rural areas. In this podcast series of three episodes, a cardiovascular specialist, an endocrinologist, and a primary care physician will provide practical guidance for primary care physicians on optimal identification and management of heart failure in patients with diabetes. In this, the third episode, we discuss practical approaches for physicians to work collaboratively to improve cardiovascular outcomes in patients with type 2 diabetes, leveraging the skills of diabetes care and education specialists, dietitians, advanced practice providers, and others. They highlight the importance of patient education and shared decision-making, alongside therapeutic intervention, in enabling patients to manage their conditions effectively. Podcast available for this article.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"815-822"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podcast Episode 1: A Pragmatic Overview of Heart Failure in Patients with Diabetes for Endocrinologists, Primary Care Physicians and Noncardiologist Clinicians.","authors":"Nihar R Desai, Silvio E Inzucchi, Eugene E Wright","doi":"10.1007/s13300-026-01855-7","DOIUrl":"10.1007/s13300-026-01855-7","url":null,"abstract":"<p><p>Heart failure is a growing major public health concern. Total medical costs for heart failure in the USA are expected to rise to more than US $70 billion by 2030, and this is expected to rise as the prevalence of heart failure increases owing to an aging population and the concurrent increase in risk factors for heart failure such as obesity, diabetes, and chronic kidney disease. Heart failure affects 22% of patients with type 2 diabetes and is frequently the first presentation of cardiovascular disease in these patients. One of the key challenges in heart failure treatment is early detection and diagnosis. Heart failure can present similarly to chronic obstructive pulmonary disease and is often misdiagnosed. Late diagnosis of heart failure can lead to delays in treatment initiation and poor patient outcomes. Clinicians other than specialist cardiologists, particularly endocrinologists and primary care physicians in the case of patients with diabetes, can play a key role in the early detection and diagnosis of heart failure. In this podcast series of three episodes, a cardiovascular specialist, an endocrinologist, and a primary care physician will provide practical guidance for primary care physicians on optimal identification and management of heart failure in patients with diabetes. In the first episode, we give a pragmatic overview of heart failure and practical guidance on how clinicians can identify patients most at risk of developing heart failure, tips for early detection and screening, and ultimately, how to prevent progression of heart failure in these patients. Podcast available for this article.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"799-806"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Evidence from VigiBase and Clinical Trials: A Comprehensive Pharmacovigilance Analysis of Seven Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RAs).","authors":"Jiaxun Li, Jizhou Liang, Wei Zhang, Jia He, Xiaofei Ye","doi":"10.1007/s13300-026-01872-6","DOIUrl":"10.1007/s13300-026-01872-6","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are key therapies for type 2 diabetes and obesity, regulating blood glucose by mimicking endogenous GLP-1. Despite efficacy, GLP-1 RAs are associated with adverse reactions across multiple organ systems. To address the gap in class-wide comparative safety analyses beyond previous studies limited to single drugs or organ systems, this study systematically evaluated adverse events for all approved GLP-1 RAs to identify hidden risks and support clinical decision-making.</p><p><strong>Methods: </strong>We conducted a disproportionality analysis using the World Health Organization pharmacovigilance database (VigiBase) data up to January 2025. Reporting odds ratio (ROR) and information component (IC) were calculated for seven GLP-1 RAs. Signals were considered significant when ROR₀₂₅ > 1 and IC₀₂₅ > 0. Subgroup analyses were stratified by gender and age. We aimed to synthesize and analyze existing randomized controlled trials (RCT) to validate VigiBase mining results.</p><p><strong>Results: </strong>Among 348,649 reports, gastrointestinal disorders were the most frequent System Organ Class. Notable signals included tirzepatide with \"abdominal pain\" (ROR₀₂₅ = 53.54), liraglutide with \"drug ineffective\" (ROR₀₂₅ = 31.14) and \"pancreatitis\" (ROR₀₂₅ = 4.24), exenatide with \"injection site pain\" (ROR₀₂₅ = 70.14), and albiglutide with \"device use error\" (ROR₀₂₅ = 1424.33). Male patients and younger adults (18-44 years) generally showed higher positive reporting rates.</p><p><strong>Conclusions: </strong>This study provides a comprehensive safety comparison across all seven approved GLP-1 RAs, confirming known risks and revealing drug-specific signals-such as injection-related issues and paradoxical hyperglycemia. These findings aid personalized treatment strategies and post-marketing surveillance.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":" ","pages":"853-872"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}