Glucagon-Like Peptide 1 Receptor Agonists and Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients With Type 2 Diabetes
Authors' conclusion
GLP-1 RAs were associated with an increased 1-year risk of NAION compared with DPP-4 inhibitors among adults with type 2 diabetes, particularly in younger patients, men, ever-smokers, and patients with a marked hemoglobin A1c reduction.
Study context
- Population
- Adults aged ≥18 years with physician-diagnosed T2D, U.K. Clinical Practice Research Datalink
- Exposure
- GLP-1 RA vs DPP-4i initiation
- Outcome
- Incident nonarteritic anterior ischemic optic neuropathy (NAION)
- Follow-up
- 1 year
Methodological detailsactive-comparator, new-user, target trial emulation, propensity-score fine-stratification weighting
- Active-comparator
- New-user
- Target trial emulation
- Propensity-score fine-stratification weighting
Main finding
As reported in the abstract
Incident NAION
GLP-1 RA
18.5 per 100,000
14 events
DPP-4i
7.2 per 100,000
53 events
Relative risk (95% CI)
GLP-1 RAvs DPP-4i
2.56(1.44–4.86)
- GLP-1 RA vs DPP-4i
- RD 11.3 per 100,000
Observational data: associations, not effects.
Further findings
Nonarteritic anterior ischemic optic neuropathy (NAION) risk by duration of use and subgroup
- Risk higher during first 6 months of use, diminishing with longer use
- Risk higher in patients aged <50 years, men, ever-smokers and those with ≥1% HbA1c reduction
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Glucagon-Like Peptide 1 Receptor Agonists and Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients With Type 2 Diabetes. Diabetes Care. Published 17 February 2026. doi:10.
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