Stopping GLP-1 diabetes drugs doubles heart attack, stroke or death rate, Italian study finds

Study design and main result

A team led by Antonio Ceriello of the IRCCS hospital in Milan examined records of 80,302 people with type 2 diabetes who had no established cardiovascular disease at the start. The data came from 301 Italian clinics and covered 2004 to 2024. The findings were published in The Lancet Regional Health Europe on 9 November 2026. About 60.5% of participants had stopped their treatment. According to the European Medicines Agency, Ozempic contains semaglutide, is authorised for type 2 diabetes and is given as a weekly injection, but most study participants had taken liraglutide or dulaglutide, only a small share semaglutide, and none tirzepatide.

To compare like with like, the researchers selected two groups of 28,713 people with similar starting characteristics, and the average age was just under 65. Over the following three to four years, stopping was linked to roughly double the incidence of a combined outcome: non-fatal heart attack, non-fatal stroke or death from any cause. The rate was 3.94 events per 100 person-years after stopping, compared with 1.96 during treatment. Person-years measure follow-up time, so these rates do not equal the share of all participants who had an event.

Stopped treatment3.94

During treatment1.96

Stopped treatment

3.94 events per 100 person-years

During treatment

1.96 events per 100 person-years

Data from the article text

Mortality and limits of the study

Deaths from any cause were also higher. The all-cause mortality rate was 2.23 per 100 person-years after stopping, against 0.48 during treatment. El Confidencial reports this as a 4.67-fold rise, while Tages Anzeiger gives a factor of 4.8.

Stopped treatment2.23

During treatment0.48

Stopped treatment

2.23 deaths per 100 person-years

During treatment

0.48 deaths per 100 person-years

Data from the article text

Weight and blood sugar had not worsened enough by themselves to account for the higher risk. The excess appeared greater among people who were still obese, and it showed up whether or not patients regained weight or saw their blood sugar and blood pressure rise. The authors stressed that the study is observational, so causal links are hard to draw. They noted that people who stopped could already have been in poorer health, and the reasons for stopping were not taken into account, though side effects, cost, frailty or cancer may have played a part.

Expert reactions

Jochen Seufert, head of the endocrinology and diabetology department at the University Hospital Freiburg in Germany, said the result did not surprise him. He is vice-president of the German Society for Endocrinology.

“GLP-1 receptor agonists only work for as long as you take them.”

Sonya Babu-Narayan, clinical director at the British Heart Foundation and a consultant cardiologist, said the findings suggest a higher risk of future heart attack, stroke or death for people who stop GLP-1 medicines. She also stressed important caveats, including the observational design, and said more research is needed.

What it means for patients

N-tv reports that doctors advise close medical supervision for patients who consider stopping these drugs. The team wrote that continuous treatment may be needed to reach the maximum benefit for cardiovascular events and mortality. The researchers also said it is difficult to draw causal conclusions from the study data, and that stopping may simply signal a higher underlying risk rather than directly cause harm. Weight loss itself tends to improve blood pressure, inflammation and cholesterol, and GLP-1 drugs are already thought to reduce inflammation and improve blood vessel function.