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# GLP-1 receptor agonists versus other diabetes drugs across 181 outcomes in type 2 diabetes
- URL: https://www.coios.me/glp-1-receptor-agonists-versus-other-diabetes-drugs-across/
- Published: 2026-10-31T11:16:49.000Z
- Updated: 2026-10-31T11:51:50.000Z
- Description: Against other diabetes drugs, GLP-1 receptor agonists were linked to lower cardiovascular and renal risk but higher musculoskeletal risk.
- Author: Daniel Ryan
- Tags: Health today, Obesity, diabetes and GLP-1, United States, #peer-reviewed, #refines, #item, #source-2026-10, #score-75

A target trial emulation compared adults with type 2 diabetes starting GLP-1 receptor agonists, sulfonylureas, SGLT2 or DPP-4 inhibitors. Records from five University of California centres, 2012 to 2025, gave 70,982 propensity-matched adults followed up to five years. Of 181 outcomes screened, 118 associations met robustness criteria, including false discovery rate control and E-values of at least 1.5\. Of these, 65 showed lower risk, including acute myocardial infarction (HR 0.53) and nephritis/nephrosis (HR 0.73). Higher risks included osteoarthritis (HR 1.48), stress fractures (HR 1.68), diverticular disease (HR 1.18 to 1.33) and sleep-wake disorders. The design is observational, so these are associations, drawn from academic medical centres only.

*Why it is interesting: The study sets lower cardiovascular and renal risks against higher musculoskeletal and gastrointestinal risks in one population. It compares new users of each drug class with one another, rather than with people taking no diabetes drug.*

Source

[Journal of Diabetes Science and Technology, 28 October 2026](https://doi.org/10.1177/19322968261498914?ref=coios.me)

Paper

Multisystem Outcomes of GLP-1 Receptor Agonists Versus Active Comparators in Type 2 Diabetes: A Multicenter Target Trial Emulation

Authors

Vashisht R, Dhruva SS, Patel A, Dahm L, Morris P, Gonzalez D et al.

DOI

10.1177/19322968261498914

Type

Peer-reviewed article

Design

Target trial emulation in harmonised EHR data from five University of California centres, 2012-2025; 70,982 propensity-matched new initiators of GLP-1RA, sulfonylurea, SGLT2i or DPP4i; 181 prespecified outcomes, up to 5-year follow-up

Verdict

Refines prior evidence

Driver

[Obesity, diabetes and GLP-1](https://www.coios.me/d-obesity-diabetes/)