Glucagon-Like Peptide-1 Receptor Agonists and Risk for Gastroesophageal Reflux Disease in Patients With Type 2 Diabetes : A Population-Based Cohort Study
Authors' conclusion
The estimated effect of GLP-1 RAs compared with SGLT-2 inhibitors suggested a higher risk for GERD and its complications in patients with type 2 diabetes. Clinicians should be aware of this potential adverse effect to provide timely prevention and treatment strategies.
Study context
- Population
- Adults aged ≥18 years with T2D initiating GLP-1 RAs or SGLT-2 inhibitors between 1 January 2013 and 31 December 2021, follow-up until 31 March 2022; UK Clinical Practice Research Datalink
- Participants
- 24,708 vs 89,096
- Exposure
- GLP-1 RAs vs SGLT-2 inhibitors
- GLP-1 RAsn = 24,708
- SGLT-2 inhibitorsn = 89,096reference
- Outcome
- Incident gastroesophageal reflux disease (GERD)
- Follow-up
- 3 years
Methodological detailspropensity score fine stratification weighting, Limitation: residual confounding due to lack of information on dietary or lifestyle factors
- Propensity score fine stratification weighting
- Limitation: residual confounding due to lack of information on dietary or lifestyle factors
Main finding
As reported in the abstract
3 years; median follow-up 3.0 years
Each group vs SGLT-2 inhibitorsRelative risk (95% CI)
GLP-1 RAs
1.27(1.14–1.42)
- GLP-1 RAs
- RD 0.7 per 100 patients
Observational data: associations, not effects.
Secondary outcomes
| Outcome | RR (95% CI) | |
|---|---|---|
| GERD complications · 3 years; median follow-up 3.0 yearsGLP-1 RAsvs SGLT-2 inhibitors | 1.55 (1.12–2.29) | |
| 0.512Relative risk (log scale) |
| Outcome | RD (per 1000 patients) |
|---|---|
| GERD complications · 3 years; median follow-up 3.0 yearsGLP-1 RAs vs SGLT-2 inhibitors | 0.8 |
Original publication
Glucagon-Like Peptide-1 Receptor Agonists and Risk for Gastroesophageal Reflux Disease in Patients With Type 2 Diabetes : A Population-Based Cohort Study. Ann Intern Med. Published 15 July 2025. doi:10.
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