Efficacy and safety of glucagon‐like peptide 1 receptor agonists across all health outcomes in type 2 diabetes: An umbrella review and evidence map of randomised controlled trials
Authors' conclusion
In this study, GLP-1RAs were associated with cardiovascular, renal, and metabolic benefits in type 2 diabetes without increasing cancer risk, though gastrointestinal adverse events were common. Our findings support the clinical use of GLP-1RAs, with attention to individual risk profiles and treatment tolerability.
Study context
- Population
- Patients with T2D in randomised controlled trials (RCTs) included in meta-analyses; 65 outcomes across 6 clinical domains17 studies · 432 RCTs
- Comparison
- GLP-1 RA vs comparators
- Outcome
- Health outcomes with GLP-1 RA use (eOR)
Methodological detailsrandom-effects models, equivalent odds ratios, AMSTAR 2, GRADE certainty of evidence, preregistered protocol, Search of PubMed/MEDLINE, Embase, CINAHL and Google Scholar through June 13, 2025
- Random-effects models
- Equivalent odds ratios
- AMSTAR 2
- GRADE certainty of evidence
- Preregistered protocol
- Search of PubMed/MEDLINE, Embase, CINAHL and Google Scholar through June 13, 2025
Pooled result
As reported in the abstract
- HF
- eOR 0.71 [0.64-0.79] (95% CI; low certainty)
- Peripheral artery disease (eOR; low certainty)
- 0.75 [0.67-0.84]
- Kidney-specific composite outcomes
- eOR 0.76 [0.66-0.87] (95% CI; low certainty)
- Nephropathy (eOR; low certainty)
- 0.74 [0.61-0.92]
- Albuminuria (eOR; very low certainty)
- 0.73 [0.55-0.97]
- Body weight
- eOR 0.46 [0.36-0.60] (95% CI; moderate certainty)
- HbA1c (eOR; high certainty)
- 0.83 [0.71-0.97]
- Cancer risk
- no substantial association
Further pooled results
Drug-specific: MACE (liraglutide), MI (albiglutide), stroke (dulaglutide)
- Liraglutide, MACE
- eOR 0.86 [0.80-0.91] (95% CI)
- Albiglutide, MI (eOR)
- 0.65 [0.47-0.89]
- Dulaglutide, stroke (eOR)
- 0.78 [0.68-0.90]
BMD
- Higher lumbar spine BMD
- eOR 1.99 [1.38-2.85] (95% CI; low certainty)
- Higher hip-neck BMD (eOR; low certainty)
- 1.79 [1.08-2.98]
Safety
Gastrointestinal adverse events
- Nausea (eOR; high certainty)
- 9.62 [4.60-20.10]
- Dyspepsia (eOR; moderate certainty)
- 4.85 [1.52-15.45]
- Constipation (eOR; high certainty)
- 3.39 [1.54-7.47]
- Consistently reported
Original publication
Efficacy and safety of glucagon‐like peptide 1 receptor agonists across all health outcomes in type 2 diabetes: An umbrella review and evidence map of randomised controlled trials. Diabetes Obes Metab. Published 19 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →