“The 41% lower risk of death from any cause surprised me most,” said Vinicius de Sousa Barzon Serra, M.D., a research fellow in cardiovascular medicine at the Mayo Clinic in Scottsdale, Arizona, according to Fox News. Adults with prediabetes and obesity using GLP-1-based medications experienced a 31% lower risk of developing type 2 diabetes and a 41% lower risk of death over three years versus those on metformin.
256,492 Patients Tracked Over Three Years
The observational study examined health records for 256,492 adults with prediabetes and obesity, averaging 52 years of age. Roughly half received GLP-1 receptor agonists — including semaglutide, tirzepatide, liraglutide and dulaglutide — while the other half received metformin, the oral medication long considered the first-line treatment for type 2 diabetes and sometimes prescribed to delay progression from prediabetes.
In addition to diabetes and mortality, GLP-1-based medications were linked to 20% fewer strokes, 15% fewer heart attacks and 25% fewer cases of heart failure, according to Fox News.
Why Serra Says the Prediabetes Stage Matters
“I expected GLP-1 medications to do better than metformin on blood sugar and diabetes risk, because they lead to much more weight loss,” Serra told Fox News Digital. “I was also struck that the benefit appeared across many outcomes, including heart attack, stroke, heart failure and atrial fibrillation.”
Nearly 40% of U.S. adults have prediabetes, according to American Heart Association statistics, and as many as 10% of them progress to type 2 diabetes each year. “Most earlier research on these medications focused on people who already had diabetes,” Serra noted. “Our study suggests the prediabetes stage may be an important time to consider them, rather than waiting until they develop type 2 diabetes.”
Study Limits: Association, Not Proof
The findings are set to be presented at the American Heart Association’s Scientific Sessions 2026 in Chicago and have not yet undergone full peer review. Because the study is observational, it does not prove the drugs caused the better outcomes, Serra said. Researchers matched patients by age, health conditions and other characteristics, but “other differences between the groups may remain,” and grouping all GLP-1 medications together meant individual drugs could not be compared. Electronic health records may have contained missing or incorrect information, and unmeasured factors such as dosage and compliance could have influenced the results.
What Doctors Advise Patients to Do
Serra advised that people with prediabetes and obesity should talk with their doctor about all options and not stop or change any medication on their own. “Metformin is a safe, inexpensive option with a long track record, and lifestyle changes such as healthy eating, regular physical activity and weight management remain the foundation of treatment,” he said. “For some patients, a GLP-1 medication may be worth discussing, depending on their overall health, other medical conditions, cost and access. The decision should be made together with their doctor.”
Questions Readers Are Asking About GLP-1s and Prediabetes
The study included the GLP-1 medications semaglutide, tirzepatide, liraglutide and dulaglutide. The study covered semaglutide, tirzepatide, liraglutide and dulaglutide, grouped together so individual drugs could not be compared.
The results are scheduled for presentation at the American Heart Association’s Scientific Sessions 2026 in Chicago and remain preliminary until published in a peer-reviewed journal.
How many Americans have prediabetes? Nearly 40% of U.S. adults, according to American Heart Association statistics, with up to 10% progressing to type 2 diabetes each year.
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