Sustained GLP-1 RA Exposure Linked to Better Metabolic Outcomes in Older Adults

Researchers conducted a retrospective cohort study using Clalit Health Services data in Israel. They included adults aged 65 years or older without diabetes who had obesity at baseline and paired BMI measurements. Exposure was classified as minimal (one or two dispensations) or sustained (three or more). The primary outcome was improvement in BMI category; secondary outcomes included HbA1c category changes and diagnosed diabetes.

Of 13,387 participants, 11,121 (83%) had sustained exposure and 2,266 (17%) had minimal exposure. BMI category improved in 55% of the sustained-exposure group versus 30% of the minimal-exposure group; median BMI changes were −8% and −2%, respectively. Among 7,392 participants with paired HbA1c results, categories improved in 34% versus 20%. Among those with prediabetes, 65% versus 37% became normoglycaemic. Diagnosed diabetes was recorded in 2.5% versus 5.3%. After adjustment for measured factors, sustained exposure was associated with BMI improvement (odds ratio 2.77, 95% CI 2.51–3.06).

The results show associations, not a proven causal effect. The retrospective comparison may be affected by confounding, and the abstract does not identify individual GLP-1 RAs or provide further details on treatment duration.