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GLP-1 RAs vs insulin in obesity-associated CANCs
One influential analysis in adults with type 2 diabetes and overweight/obesity used a “target-trial emulation” design to compare outcomes in patients started on GLP-1 receptor agonists vs those started on basal insulin. Focusing on obesity-associated CANCs as
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- One influential analysis in adults with type 2 diabetes and overweight/obesity used a “target-trial emulation” design to compare outcomes in patients started on GLP-1 receptor agonists vs those started on basal insulin. Focusing on obesity-associated CANCs as a group, investigators found that GLP-1 RA use was associated with a lower incidence of certain obesity-related CANCs—including colorectal, pancreatic, and liver CANCs—compared with insulin therapy over several years of follow-up. The protective association was most pronounced in individuals with higher BMI, who also saw the largest improvements in weight and glycemic control.
- These findings suggest that, at least compared with insulin, GLP-1 drugs may be more favorable from an obesity-associated CANC standpoint in patients with type 2 diabetes. This does not mean insulin is “bad” or that GLP-1 RAs are chemopreventive agents, but it does hint that improving weight and insulin dynamics with GLP-1 drugs could shift CANC risk trajectories over time.