GLP-1 Medications Use: Study Reveals High Restart Rates Amid Lower Discontinuation

Patients prescribed GLP-1 receptor agonists for type 2 diabetes frequently cycle on and off their medication, with nearly 6 in 10 patients discontinuing therapy within two years, according to research presented at the Endocrine Society’s annual meeting, ENDO 2026. While discontinuation rates are high, the data indicates that more than half of those who stop treatment eventually resume it, suggesting a pattern of intermittent use rather than permanent abandonment.

Understanding GLP-1 Discontinuation Trends

A retrospective cohort study analyzed insurance claims data from over 60,000 U.S. adults with type 2 diabetes between 2019 and 2025. Researchers defined discontinuation as a gap of more than 60 days in prescription refills. The study found that approximately 40% of patients stopped their medication within the first year, rising to nearly 60% by the end of the second year. However, the “start-stop” nature of the therapy is significant; among those who discontinued, 41.5% restarted treatment within one year, and 58% resumed within two years, according to lead researcher Sainikhil Sontha of the Boston University School of Public Health.

Predictors of Treatment Adherence

Clinical and demographic factors play a measurable role in how long patients remain on GLP-1 therapy. The study identified several key predictors of early discontinuation:

• Insurance Type: Patients covered by Medicaid or Medicare were more likely to discontinue therapy compared to those with private insurance.
• Demographics: Black patients showed higher rates of discontinuation within the first year.
• Side Effects: Gastrointestinal issues, such as nausea, were a primary driver for stopping, affecting 37% of the study population.
• Provider Specialty: Patients whose initial prescription came from an endocrinologist were 10% less likely to discontinue treatment.

Impact of Medication Choice on Persistence

The specific type of GLP-1 medication influences how long patients continue treatment. Newer medications show higher retention rates than older counterparts. Patients taking tirzepatide were 41% less likely to discontinue compared to those on liraglutide, while semaglutide users were 28% less likely to stop than the older drug cohort. These findings suggest that the clinical profile and tolerability of newer agents may improve long-term adherence, which is vital for preventing complications like kidney disease and cardiovascular events.

Clinical Implications for Long-Term Management

Consistent use of GLP-1 agonists is essential for maintaining blood glucose control and achieving the long-term protective effects associated with these drugs. The high rate of temporary discontinuation highlights a need for clinicians to provide more robust support, particularly during the first few months of treatment when gastrointestinal side effects are most prevalent. By identifying patients at higher risk of stopping, healthcare providers can offer targeted education and management strategies to help sustain therapy. Policymakers and insurers may also use these findings to evaluate access barriers that contribute to gaps in treatment.

Quick Facts: GLP-1 Treatment Patterns