People with diabetes who stopped GLP-1 drugs such as Ozempic had about twice the rate of heart attacks, strokes and deaths, a study of 80,000 patients finds

People with type 2 diabetes who stopped taking a GLP-1 drug had about twice the combined rate of heart attacks, strokes and deaths as similar people who kept taking it, according to a study published this week in the medical journal The Lancet Regional Health – Europe.

GLP-1 drugs, a class that includes semaglutide (sold as Ozempic), copy a gut hormone to lower blood sugar and body weight.  In clinical trials they cut heart attacks, strokes and deaths in people with type 2 diabetes.  Yet 20% to 50% of patients stop within the first year, the authors wrote.

What it found

• People who stopped had about 3.9 heart attacks, strokes or deaths per 100 people per year.  People who stayed on the drug had about 2.
• Deaths from any cause were about 2.2 per 100 people per year among those who stopped and 0.5 among those who continued, more than four times as high.  The authors said a gap that large is unlikely to come from stopping the drug alone.
• The link was stronger in people with obesity.
• Weight, blood sugar and blood pressure changed only modestly after people stopped, so those changes may not explain the extra risk.

How the study was done

Researchers led by IRCCS MultiMedica, a research hospital in Milan, used medical records collected from 2004 to 2024 at 301 diabetes clinics across Italy.  They found 80,302 adults with type 2 diabetes and no heart disease who started a GLP-1 drug, and 60.5% of them later stopped.  To compare like with like, they matched 28,713 people who stopped with 28,713 similar people who stayed on the drug and followed them for about four years.

Limits

This was an observational study.  It looked back at records instead of randomly assigning people to stop or continue, so it can’t show that stopping caused the harm.  The records didn’t say why people stopped.  Serious illness such as frailty or cancer can lead people to stop medicines and also raises the risk of death, the authors noted.  Few patients took semaglutide, none took tirzepatide (sold as Mounjaro and Zepbound), and everyone had diabetes, so the results may not apply to people taking these drugs only for weight loss.  Several authors have been paid advisers or speakers for drugmakers, including Novo Nordisk and Eli Lilly, which make GLP-1 drugs.

What readers can do

• If you take a GLP-1 drug for diabetes and are thinking about stopping, talk with your doctor first.  The authors concluded that staying on the drugs long term may be important to keep their protection against heart attacks, strokes and death.
• If stomach side effects are the problem, ask about raising the dose more slowly or more flexibly.  The authors recommended that approach to help people stay on treatment.

Sources:  Ceriello et al., The Lancet Regional Health – Europe (2026); full text of the open-access paper (PDF).