Glucagon-like peptide-1 receptor agonists and risk of suicidality among patients with type 2 diabetes: active comparator, new user cohort study
An erratum to this article was published (BMJ, 28 Apr 2025 ↗)
Authors' conclusion
In this large cohort study, the use of GLP-1 receptor agonists was not associated with an increased risk of suicidality compared with the use of DPP-4 inhibitors or SGLT-2 inhibitors in patients with type 2 diabetes.
Study context
- Population
- Patients with T2D, UK primary care practices (Clinical Practice Research Datalink)two cohorts
- Participants
- 36,082 / 234,028 / 32,336 / 96,212
- Exposure
- GLP-1 RA vs DPP-4i; GLP-1 RA vs SGLT2i
- GLP-1 receptor agonistsn = 36,082
- DPP-4 inhibitorsn = 234,028reference
- GLP-1 receptor agonistsn = 32,336
- SGLT-2 inhibitorsn = 96,212reference
- Outcome
- Suicidality: composite of suicidal ideation, self-harm and suicide
Methodological detailspropensity score fine stratification weighted Cox models, UK Clinical Practice Research Datalink linked to HES and ONS death registration, Followed until 29 March 2021
- Propensity score fine stratification weighted Cox models
- UK Clinical Practice Research Datalink linked to HES and ONS death registration
- Followed until 29 March 2021
Main finding
As reported in the abstract
Suicidality:
- Suicidal ideation
- Self-harm
- Suicide
GLP-1 receptor agonists
3.9 per 1000 person years
DPP-4 inhibitors
1.8 per 1000 person years
GLP-1 receptor agonists
4.3 per 1000 person years
SGLT-2 inhibitors
2.7 per 1000 person years
Hazard ratio (95% CI)
GLP-1 receptor agonistsvs DPP-4 inhibitorscohort 1; after confounding factors accounted for
1.02(0.85–1.23)
GLP-1 receptor agonistsvs DPP-4 inhibitorscohort 1; crude
2.08(1.83–2.36)
GLP-1 receptor agonistsvs SGLT-2 inhibitorscohort 2; after confounding factors accounted for
0.91(0.73–1.12)
GLP-1 receptor agonistsvs SGLT-2 inhibitorscohort 2; crude
1.60(1.37–1.87)
Observational data: associations, not effects.
Secondary outcomes
Suicidal ideation, self-harm and suicide separately
- Similar findings in both cohorts
Original publication
Glucagon-like peptide-1 receptor agonists and risk of suicidality among patients with type 2 diabetes: active comparator, new user cohort study. BMJ. Published 26 February 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →