Adults with prediabetes and obesity who took GLP-1-based weight-loss drugs were 31% less likely to progress to type 2 diabetes over three years than similar patients who took metformin, according to a U.S. study of more than 256,000 people, cairo24.com reported. The same analysis found the GLP-1 group had a 41% lower risk of death from any cause during the follow-up period.
The study, which compared semaglutide, tirzepatide, liraglutide and dulaglutide against metformin, also linked the newer drugs to lower rates of stroke, heart attack and heart failure. The findings are scheduled for presentation at the American Heart Association’s 2026 scientific sessions in Chicago from Nov. 6 to 9.
256,492 Adults Tracked Through the TriNetX Network
Researchers analyzed electronic health records for 256,492 adults with prediabetes and obesity, with an average age of 52; women made up 76% of participants, arab48.com reported. Roughly half received a GLP-1 receptor agonist — including tirzepatide, which acts on both GIP and GLP-1 receptors — while the other half took metformin, the long-standing standard for treating and sometimes preventing type 2 diabetes.
The data came from TriNetX, a global network of health records covering 104 institutions, with information collected between 2010 and 2023 and an average follow-up of about three years, asharq.com reported. Researchers adjusted for factors including high blood pressure, sleep apnea and nicotine dependence.
Heart Benefits Extend Beyond Diabetes Prevention
The advantages were not limited to diabetes. Compared with the metformin group, GLP-1 users showed a 20% lower risk of stroke, a 15% lower risk of heart attack, a 25% lower risk of heart failure and an 8% lower risk of atrial fibrillation, a common heart-rhythm disorder, according to results reported by arab48.com.
GLP-1 users were also about 1.5 times more likely to return to normal blood-sugar levels than metformin users.
Researcher Calls the 41% Mortality Drop the Biggest Surprise
He noted that most prior research on these drugs focused on people who already had type 2 diabetes, while the new results point to their potential role earlier, during the prediabetes stage.
Weight loss helps prevent prediabetes from progressing to type 2 diabetes and can in turn reduce the risk of heart attacks and strokes. Eckel also cautioned that the drugs’ high cost and limited availability are important factors when considering broader use.
Why the Results Are Not Yet Proof
The researchers stressed that the study was observational, not a randomized clinical trial, so it cannot prove the drugs themselves directly caused the lower rates of diabetes and death, asharq.com reported. The analysis relied on electronic health records, which can contain incomplete or inaccurate data, and could not determine the doses patients actually took or how consistently they took them. The results remain preliminary and have not yet undergone full peer review.
What Happens Next: AHA Sessions in Chicago, Nov. 6–9
The full results are set to be presented during the American Heart Association’s annual scientific sessions in Chicago from Nov. 6 to 9, 2026. The researchers said lifestyle changes — healthy eating, physical activity and weight management — remain essential for preventing type 2 diabetes whether or not medication is used, and that more studies are needed to confirm the benefits and identify which patients stand to gain the most.
Drugs Examined in Study Reveal Key Differences
Which drugs were included in the study?
The GLP-1 group included semaglutide, liraglutide, dulaglutide and tirzepatide, which acts on both GIP and GLP-1 receptors. The comparison group took metformin.
How many people participated and for how long?
The study analyzed records of 256,492 adults with an average age of 52, drawn from 104 health institutions in the TriNetX network, with an average follow-up of about three years between 2010 and 2023.
Are these findings final?
No. The researchers describe the results as preliminary; they have not yet been peer-reviewed or published in a scientific journal and are scheduled for presentation at the American Heart Association’s 2026 meeting in Chicago.
The study’s authors say the new data could expand the role of weight-loss drugs in early intervention — a question the Chicago presentation is expected to address further.
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