Synergistic associations of metformin and GLP ‐1 receptor agonist use with adiposity‐related cancer incidence in people living with type 2 diabetes
Authors' conclusion
In patients with T2D, dual metformin and GLP-1 RA treatment was associated with a 39% lower incidence of adiposity-related cancers and a 67% lower mortality, with a striking impact on cancer-related outcomes.
Study context
- Population
- Patients with T2D in a large global database (TriNetX)matched cohorts
- Exposure
- Metformin, GLP-1 RA or dual metformin/GLP-1 RA vs DPP4 inhibitors (DPP4i)
- Outcome
- Adiposity-related cancer incidence and all-cause mortality
- Follow-up
- 5 years
Methodological detailspropensity-score matched (1:1), large global database (TriNetX)
- Propensity-score matched (1:1)
- Large global database (TriNetX)
Main finding
As reported in the abstract
All adiposity-related cancers · 5 years
Each group vs DPP4iHazard ratio (95% CI)
Metformin
0.96(0.92–0.99)
GLP-1 RA
0.86(0.82–0.89)
Dual therapy
0.61(0.57–0.65)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| All-cause mortality · 5 yearsMetforminvs DPP4i | 0.78 (0.76–0.80) | |
| All-cause mortality · 5 yearsGLP-1 RAvs DPP4i | 0.61 (0.59–0.63) | |
| All-cause mortality · 5 yearsDual therapyvs DPP4i | 0.33 (0.32–0.35) | |
| 0.20.5125Hazard ratio (log scale) |
Subgroups
- Results were more significant in younger, male patients with obesity
Original publication
Synergistic associations of metformin and GLP ‐1 receptor agonist use with adiposity‐related cancer incidence in people living with type 2 diabetes. Diabetes Obes Metab. Published 3 November 2025. doi:10.
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