Glucagon-Like Peptide-1 Receptor Agonists and Risk for Suicidal Ideation and Behaviors in U.S. Older Adults With Type 2 Diabetes : A Target Trial Emulation Study
Authors' conclusion
Among Medicare beneficiaries with T2D, this study found no clear increased risk for suicidal ideation and behaviors with GLP-1 RAs, although estimates were imprecise and a modest adverse risk could not be ruled out.
Study context
- Population
- Older adults (≥66 years) with T2D, no record of suicidal ideation or behaviors, first prescription for a GLP-1 RA, SGLT2i or DPP-4i; US Medicare data, January 2017 to December 202021,807 and 21,402 matched pairs
- Comparison
- GLP-1 RA vs SGLT2i and GLP-1 RA vs DPP-4i
- Outcome
- Composite of:
- Suicidal ideation
- Behaviors
Methodological detailstwo target trial emulations, propensity score-matched 1:1, new-user design
- Two target trial emulations
- Propensity score-matched 1:1
- New-user design
Main finding
As reported in the abstract
Suicidal ideation and behaviors
Hazard ratio (95% CI)
GLP-1 RAvs SGLT2i21 807 matched pairs
1.07(0.80–1.45)
GLP-1 RAvs DPP-4i21 402 matched pairs
0.94(0.71–1.24)
Rate difference, per 1000 person-years (95% CI)
GLP-1 RAvs SGLT2i
0.16(−0.53 to 0.86)
GLP-1 RAvs DPP-4i
−0.18(−0.92 to 0.57)
Original publication
Glucagon-Like Peptide-1 Receptor Agonists and Risk for Suicidal Ideation and Behaviors in U.S. Older Adults With Type 2 Diabetes : A Target Trial Emulation Study. Ann Intern Med. Published 16 July 2024. doi:10.
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