Glucagon‐Like Peptide‐1 Based Therapies and the Risk of Severe Gastrointestinal Motility Adverse Events: A Cohort Study
Authors' conclusion
The absolute risk of motility-related gastrointestinal adverse events was 1% or less but was higher among initiators of GLP-1 based therapies compared to SGLT-2i.
Study context
- Population
- Adults with T2D without prior major gastrointestinal conditions initiating GLP-1 based therapies or SGLT2i; mean age 60 years, 45% female313,342 matched pairs
- Exposure
- GLP-1 based therapies vs SGLT2i
- Outcome
- Composite of:
- Severe constipation
- Gastroparesis
- Gastrointestinal obstruction
- Follow-up
- On treatment, median 5.2 months
Methodological detailsnew-user active-comparator, propensity score matching, two US commercial healthcare databases
- New-user active-comparator
- Propensity score matching
- Two US commercial healthcare databases
Main finding
As reported in the abstract
Composite severe motility-related GI adverse events
Each group vs SGLT-2iHazard ratio (95% CI)
GLP-1 based therapies
1.37(1.30–1.45)
- GLP-1 based therapies
- rate difference 0.27 per 100 person-years
Observational data: associations, not effects.
Further findings
Individual components (severe constipation, gastroparesis, GI obstruction)
- Risk higher with GLP-1 based therapies vs SGLT2i for each individual component
Subgroups (agent, age, sex, BMI, frailty, diabetes severity, opioid use)
- Relative increased risk consistent across subgroups
Original publication
Glucagon‐Like Peptide‐1 Based Therapies and the Risk of Severe Gastrointestinal Motility Adverse Events: A Cohort Study. Diabetes Obes Metab. Published 4 June 2026. doi:10.
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