Over 10-Year Study Period, GLP-1 Drug Use Reduced Risk of Developing DR and DME

Dedicated study of GLP-1 receptor agonist use for its eye-related risks is essential to understand the screening and treatment burden of this increasingly popular drug class. Photo: Optos. Click image to enlarge. Glucagon-like peptide-1 (GLP-1) receptor agonist therapy has been a major success story in the treatment of diabetes and obesity in recent years. As these powerful meds have demonstrated both positive and negative effects on ocular health, researchers consider this medication class a fruitful area of study. To that end, researchers from UCLA’s Jules Stein Eye Institute recently examined associations between GLP-1 agonists, diabetic retinopathy (DR) and diabetic macular edema (DME), including treatment-requiring DR/DME, in diabetes patients from a large, diverse database.In this 10-year study, GLP-1 receptor agonist use was associated with a decreased likelihood of developing DR, DME and treatment-requiring DR/DME across the follow-up period. This suggests that GLP-1 use may provide a significant protective effect against diabetes’s ocular complications, including the most severe vision-threatening complications that require vitreoretinal intervention.In their paper for Retina, the researchers noted that GLP-1 drugs “are likely protective of poor visual outcomes, although further research is needed to determine whether these medications remain protective when initiated after DR development.” A total of 37,258 participants with type 2 diabetes were included in the study, of whom 14.1% were GLP-1 agonist users. The distribution of race and ethnicity among total participants was 51.8% Caucasian, 25.4% Black, 18.1% Hispanic, 2.9% other and 1.8% Asian. Compared with nonusers, diabetes patients on a GLP-1 agent were more likely to be younger (mean age: 50.6 in users vs. 54.4 in nonusers), Caucasian (57.1% vs. 51.0%), female (61.9% vs. 55.9%) and have income >$50,000 (40.5% vs. 35.8%).Compared with those not on these drugs, GLP-1 agonist use was associated with a decreased risk of DR (hazard ratio, HR: 0.31), DME (HR: 0.40) and treatment-requiring DR/DME (HR: 0.18). The mean time-to-event was significantly longer in the GLP-1 treatment group compared with untreated patients for DR (62.1 vs. 43.9 months), DME (71.1 vs. 50.3 months) and treatment-requiring DR/DME (84.4 vs. 44.5 months).Analysis of covariates for this racially and ethnically diverse study population highlighted potential disparities for non-Caucasian racial and ethnic groups. A statistically significant increased risk of DR was observed for participants of Hispanic or Latino or Other race and ethnicity. Black, Hispanic or Latino, and other populations were at an increased risk of developing DME, and Black and Hispanic or Latino populations demonstrated an increased risk of treatment-requiring DR/DME.Compared with nonuser data, GLP-1 receptor agonist use in this study “was associated with a decreased likelihood of any DR or DME, including mild disease and severe disease requiring a vitreoretinal procedure compared with no disease,” the researchers noted in their paper. “Furthermore, the risk of severe DME requiring a procedure may be decreased compared with mild DME, but future studies should seek to better distinguish these associations, including potential disparities due to race and ethnicity.”Click here for the journal source. Talebi R, Fortes BH, Yu F, et al. Real-world associations between glucagon-like peptide-1 receptor agonist use and diabetic retinopathy accounting for longitudinal glycemic control. Retina. 2025;45(9):1663-71. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.