A study of more than 80,000 Italians with type 2 diabetes and no established heart disease found that people who stopped GLP-1 treatment had roughly twice the annual rate of serious cardiovascular events or death as those who continued—about four versus two per 100 people.

Published in Lancet Regional Health Europe, the study analyzed records collected from 2004 to 2024 at more than 300 Italian diabetes clinics; around 60% of participants stopped treatment, typically after about a year, while those who continued used it for nearly three years on average.

The annual death rate was also higher among those who stopped, at about 2.2 per 100 people compared with 0.5 among those who continued.

The association was strongest among people with obesity: stopping treatment was linked to a 127% increase in cardiovascular risk, compared with a 61% increase among those without obesity.

After treatment ended, weight, blood sugar and blood pressure changed only modestly, and these measures did not explain the higher risk; the researchers cautioned that the findings may not apply to people taking GLP-1 drugs without type 2 diabetes.

Dr. Christopher Labos said the results fit the possibility that patients lose some cardiovascular benefit when they discontinue treatment, and cautioned against stopping simply because the medication seems to have worked.

Faye Riley of Diabetes UK emphasized the importance of ongoing care and supervision for people receiving these treatments.

Because the study was observational, it cannot show that stopping GLP-1s caused the higher risk; people who discontinued may already have had poorer health or greater underlying cardiovascular risk, and further research is needed to distinguish cause from a warning sign of worsening health.

Most participants used earlier-generation medicines, particularly liraglutide or dulaglutide; semaglutide was used by only a small group, and tirzepatide was not included because it entered the Italian market after the study period.