Glucagon-like peptide-1 receptor agonists (GLP-1) may not be linked to an increased risk for diabetic retinopathy in individuals with type 2 diabetes (T2D), according to a study published in Diabetes Care.

Researchers relied on the UK Clinical Practice Research Datalink to conduct a cohort study of 77,115 individuals with T2D who were prescribed anti-diabetic drugs between January 2007 and September 2015. They then compared individuals using GLP-1 receptor agonists to new users of insulin.

GLP-1 receptor agonists compared with individuals taking 2 or more oral anti-diabetic drugs did not reveal a higher risk of developing diabetic retinopathy (crude incidence rates, 40.4 vs 49.0 per 1,000/ year; adjusted hazard ratio [HR] 1.00; 95% CI, 0.85-1.17). 

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However, receiving the treatment over a longer period of time—between 6.1 and 12 months—was linked with a 44% increased risk of developing diabetic retinopathy (crude incidence rates, 56.6 vs 45.9 per 1,000/year; adjusted HR 1.44; 95% CI, 1.06-1.95) in individuals with T2D. Compared with insulin, GLP-1 receptor agonists was also associated with a 33% decreased risk for diabetic retinopathy in individuals with T2D (adjusted HR 0.67; 95% CI, 0.51-0.90).

Researchers concluded that “GLP-1 [receptor agonists] is not associated with an increased risk [for] diabetic retinopathy overall. Although there was a suggestion of a transient increased risk with duration of use ranging between 6 and 12 months.” Researchers also stressed that study results may be due to residual confounding and should be viewed with care.

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Disclosures: Multiple authors declare affiliations with drug companies. Please see reference for a complete list of disclosures.


Douros A, Fillion K, Yin H, et al. Glucagon-like peptide-1 receptor agonists and the risk of incident diabetic retinopathy [published online August 27, 2018]. Diabetes Care. doi: 10.2337/dc17-2280