Adults with prediabetes and obesity who took GLP-1 medications were about 1.5 times more likely to reverse their blood sugar to normal levels compared with those taking metformin, according to preliminary research presented at the American Heart Association's Scientific Sessions 2026 in Chicago. The study, which reviewed health records for more than 250,000 adults, also found that GLP-1 users had a 31% lower risk of developing Type 2 diabetes and a 41% lower risk of death from any cause over a five-year period. The findings were presented at the meeting, which runs Nov. 6-9 and is a premier global exchange of cardiovascular science.
The research is among the largest to evaluate GLP-1 medications—currently popular for weight loss—against metformin, the gold-standard first-line treatment for prediabetes and Type 2 diabetes. Nearly 40% of U.S. adults have prediabetes, according to the American Heart Association's 2026 Heart Disease and Stroke Statistics, and up to 10% of them progress to Type 2 diabetes each year. The new study suggests GLP-1s could alter that trajectory.
Compared with metformin, GLP-1 medications were associated with 15% fewer heart attacks, 20% fewer strokes, 25% fewer cases of heart failure and 8% fewer cases of atrial fibrillation. The analysis included 256,492 adults (average age 52, 76% women) with prediabetes and obesity, using data from the TriNetX global health record network across 104 institutions from 2010 to 2023. About half took GLP-1 medications such as semaglutide, tirzepatide, liraglutide or dulaglutide, while the other half took metformin.
"The great news with prediabetes is that it's still possible to reverse the progression of the disease," said study author Vinicius de Sousa Barzon Serra, M.D., a research fellow in cardiovascular medicine at the Mayo Clinic in Scottsdale, Arizona. "This research may add to the case for considering GLP-1 medications earlier for certain patients, rather than waiting until they develop Type 2 diabetes." Serra emphasized that metformin remains a first-line treatment and that lifestyle changes are essential.
Robert Eckel, M.D., FAHA, a past volunteer president of the American Heart Association who was not involved in the study, said the benefits likely relate to weight loss. "GLP-1s provide another option for prevention, perhaps as an add-on therapy," Eckel said. "However, costs and access to these medications are important factors."
The study is observational and cannot prove cause and effect. Other limitations include reliance on diagnosis codes and prescription records, and GLP-1 agents were grouped together. The findings are considered preliminary until published in a peer-reviewed journal. The full abstract and the meeting's Online Program Planner are available, along with a Spanish news release and the original release link.
For readers, the findings may prompt discussions with healthcare providers about treatment options for prediabetes, especially given the high prevalence of the condition. The American Heart Association provides resources on heart.org and stroke.org.
