Bowel Obstruction/Ileus Associated With the Use of Glucagon‐Like Peptide‐1 Receptor Agonists: A Nationwide Database Study
Authors' conclusion
GLP-1RA initiation in individuals with type 2 diabetes was not associated with an increased risk of bowel obstruction/ileus compared with SGLT2i initiation.
Study context
- Population
- Adults aged ≥18 years with T2D newly initiating GLP-1 RAs or SGLT2i, April 2016–February 2024, Japanese DeSC claims database
- Participants
- 298,124 eligible individuals
- Exposure
- GLP-1 RA vs SGLT2i initiation
- GLP-1RAn = 25,779
- SGLT2in = 272,345reference
- Outcome
- Bowel obstruction/ileus requiring tube decompression or surgery
- Follow-up
- Within 1 year
Methodological detailsnationwide administrative claims database, active-comparator new-user design, inverse probability weighting with propensity scores
- Nationwide administrative claims database
- Active-comparator new-user design
- Inverse probability weighting with propensity scores
Main finding
As reported in the abstract
1 year
Each group vs SGLT2iDifference, % (95% CI)
GLP-1RA
−0.03(−0.10% to 0.04%)
Each group vs SGLT2iHazard ratio (95% CI)
GLP-1RA
0.80(0.52–1.24)
Observational data: associations, not effects.
Secondary outcomes
Small bowel obstruction, small bowel obstruction requiring surgery, paralytic ileus, colonic volvulus
- No significant between-group differences for the secondary outcomes
Original publication
Bowel Obstruction/Ileus Associated With the Use of Glucagon‐Like Peptide‐1 Receptor Agonists: A Nationwide Database Study. Diabetes Obes Metab. Published 9 August 2026. doi:10.
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