Association of GLP-1 receptor agonists with intentional self-harm in patients with type 2 diabetes: a Sentinel Distributed Database study
Authors' conclusion
The use of GLP-1 RAs did not show increased risk of intentional self-harm compared with SGLT-2is or DPP-4is, which provides some reassurance regarding the safety of GLP-1 RA use in patients with type 2 diabetes.
Study context
- Population
- Health plan members ≥18 years with T2D, continuously enrolled with medical and drug coverage ≥183 days; October 1, 2015 to September 30, 2023; mean age slightly above 60 years
- Participants
- 1,161,983 / 1,081,155 / 1,396,382
- Exposure
- GLP-1 RAs vs SGLT2i or DPP-4i
- GLP-1 RAsn = 1,161,983
- SGLT-2isn = 1,081,155reference
- DPP-4isn = 1,396,382reference
- Outcome
- Intentional self-harm
Methodological detailsFood and Drug Administration (FDA) Sentinel System, inverse probability of treatment weighting of propensity scores
- FDA Sentinel System
- Inverse probability of treatment weighting of propensity scores
Main finding
As reported in the abstract
GLP-1 RAs
1.13 per 1000 person-years
SGLT-2is
1.22 per 1000 person-years
DPP-4is
1.37 per 1000 person-years
Adjusted hazard ratio (95% CI)
GLP-1 RAsvs SGLT-2is
0.93(0.81–1.08)
GLP-1 RAsvs DPP-4is
0.94(0.82–1.07)
Observational data: associations, not effects.
Further findings
Subgroups by comorbid obesity and diabetes, psychiatric history, prior intentional self-harm, age and sex
- Subgroup analyses yielded similar results
Original publication
Association of GLP-1 receptor agonists with intentional self-harm in patients with type 2 diabetes: a Sentinel Distributed Database study. BMJ Open Diabetes Res Care. Published 18 March 2026. doi:10.
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