Research Highlights:

• Among more than 250,000 adults with prediabetes and obesity, those taking glucagon-like peptide-1 receptor agonists (GLP-1 medications) were about 1.5 times more likely to reverse blood sugar to normal levels compared to those taking the standard Type 2 diabetes prevention medication metformin.
• Adults taking GLP-1 medications also had a lower risk of progressing from prediabetes to Type 2 diabetes, and they had a lower risk of death from any cause over a 5-year period.
• GLP-1 medications were also associated with fewer heart attacks, strokes and heart failure events compared with metformin.
• Note: The study featured in this news release is a research abstract. Abstracts presented at American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4 a.m. CT/5 a.m. ET, Monday, Nov. 2, 2026

November 2, 2026 (NEWMEDIAWIRE) - DALLAS - GLP-1 (glucagon-like peptide-1 receptor agonists) medications, currently popular for weight-loss, may help prevent Type 2 diabetes and lower the risk of heart attack and stroke more than the standard diabetes prevention medication metformin among people with prediabetes, according to new, independent, preliminary research presented at the American Heart Association’s Scientific Sessions 2026. The meeting on Nov. 6-9 in Chicago is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

The study, which reviewed health records for more than 250,000 adults with prediabetes and obesity, is among the largest studies to evaluate the impact of GLP-1 medications compared with metformin - the current gold-standard, first-line medication for treating prediabetes and Type 2 diabetes, along with lifestyle modification.

Most prior research on GLP-1 medications focused on people who already had Type 2 diabetes, according to study author Vinicius de Sousa Barzon Serra, M.D. This study investigated the earlier prediabetes stage and captured the impact of GLP-1s on blood sugar and heart and stroke risk.

In prediabetes, blood sugar levels are above normal yet not high enough for a diabetes diagnosis. Nearly 40% of U.S. adults have prediabetes, according to the American Heart Association’s 2026 Heart Disease and Stroke Statistics. Prediabetes progresses to Type 2 diabetes for up to 10% of these adults each year, according to statistics from the National Institutes of Health.

“The great news with prediabetes is that it’s still possible to reverse the progression of the disease,” said Serra, a research fellow in the department of 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.”

In general, about 1 out of 10 U.S. adults may be take GLP-1 medications for blood sugar control or weight loss, according to 2026 healthcare survey information garnered from more than 2,800 hospitals and health systems nationwide.

In this analysis of more than 250,000 adults with prediabetes and obesity, about half were taking the GLP-1 based medications semaglutide, tirzepatide, liraglutide or dulaglutide, while the other half were taking metformin.

What were the study’s main findings?

• Compared to those taking metformin, participants in the study taking GLP-1s had:
  • a 1.5 times higher chance of reversing high blood sugar to normal levels;
  • a 31% lower risk of developing Type 2 diabetes; and
  • a 41% lower risk of death from any cause.
• GLP-1 medications were also associated with 15% fewer heart attacks, 20% fewer strokes, 25% fewer cases of heart failure and 8% fewer cases of atrial fibrillation (AFib), a common type of irregular heartbeat.

“The main effect these findings could have is on the shared decision-making discussion between doctors and patients exploring various treatment options, and the pros and cons for each,” said Serra. “Metformin is still a first-line treatment choice. It is safe, inexpensive and has a long track record. This is less about replacing one medication with another and more about discussing additional options with specific patients,” he said.

“It’s important to note that an essential component of prediabetes treatment is lifestyle changes to manage weight, including diet and exercise and considering medications, including metformin, based on each individual’s overall health and any other medical conditions,” said Serra.

American Heart Association past volunteer President, Robert Eckel, M.D., FAHA, said the findings are not surprising. “The benefits noted in this study likely relates to the patients losing weight, which is known to help prevent Type 2 diabetes,” said Eckel, professor of medicine emeritus at the University of Colorado Anschutz Medical Campus. “Preventing the progression from pre-diabetes to Type 2 diabetes keeps patients from having Type 2 diabetes, and it also helps prevent heart attack and strokes. “GLP-1s provide another option for prevention, perhaps as an add-on therapy,” said Eckel, who was not involved in this study “However, costs and access to these medications are important factors.”

Study details, background, design and limitations:

• Researchers reviewed the electronic health records for 256,492 adults (average age 52, 76% women) diagnosed with prediabetes and obesity.
• The health data was extracted from the TriNetX global multi-center electronic health record network, based on 104 institutions from 2010 to 2023 and patients were followed for average of roughly 3 years.
• The researchers compared data among people who took metformin with those who took a GLP-1 medication, analyzing how the medication affected blood sugar and the risk of Type 2 diabetes, heart disease, stroke or death.
• The researchers paired records of patients with similar ages, health conditions (such as high blood pressure, sleep apnea or nicotine dependence) and medications. This matching helped ensure any differences in health outcomes were likely from the medication itself, rather than other differences.
• The study is observational and, therefore, cannot prove a cause-and-effect relationship. Other limitations include that patients and outcomes were identified through diagnosis codes, which can be incomplete; and researchers relied on prescription records, so how consistently patients took medication or at what dose is not reflected; and GLP-1-based medications were grouped together, individual differences between agents were not considered.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia, including video interview clips with video interview with American Heart Association past volunteer President, Robert Eckel, M.D., FAHA, is available on the right column of the release link.
• Spanish news release
• Link to abstract; and the American Heart Association’s Scientific Sessions 2026 Online Program Planner
• American Heart Association news release: New guideline reframes weight as health risk tied to diabetes, kidney and heart conditions (June 2026)
• American Heart Association news release: Healthy lifestyle combined with newer diabetes medications lowered cardiovascular risk (Nov. 2025)
• American Heart Association news release: New weight loss medication may help lower blood pressure in adults with obesity (Feb. 2024)
• American Heart Association news release: Updated: Prediabetes linked to higher heart attack risk in young adults (May 2022)
• About Scientific Sessions 2026
• For more news at the American Heart Association’s Scientific Sessions 2026, follow us on X @HeartNews, #ScientificSessions26

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About the American Heart Association

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