Have GLP-1s Contributed to a Decline in Diabetes Deaths?
Over the last few decades, there have not been a lot of bright spots for metabolic health. But here’s one. A new paper in Diabetes Care tells us diabetes mortality actually dropped between 2000 and 2019. The authors, led by Hasan Nassereldine, suggest that the decline in diabetes deaths could be due to the adoption of better options for diabetes care, including GLP-1 agonists. The authors explain:
“Changes in practice and advancements in treatment and diagnosis, although applied at the individual level, have likely contributed to the declines observed in most counties and nationally because of their widespread application and integration as standard of care for people with diabetes.”
Good News/Bad News
Unfortunately, this is not 100% a good news story. The decline in diabetes deaths was far from uniform across the country. In the Southeast, especially in Georgia and Mississippi, mortality rose substantially. Mortality dropped the most for American Indian, Alaska Native, and Black persons. But even after this decline, the rate of diabetes deaths remained higher for those groups than for any other racial or ethnic group. We note that substantial racial and ethnic disparities persist in access to advanced therapies like GLP-1 agonists.
It is also worth noting that an especially steep decline in mortality in Latino populations had the effect of “nearly eliminating” disparities for this ethnic group. Another spot of good news.
Slowing Progress
Finally, it is worth noting that the progress in improving mortality slowed significantly in the latter years of this analysis. The reasons for this loss of momentum are unclear. But it is vital to have a better understanding of it, as well as as better strategies for eliminating the lingering disparities for Black and Native American persons.
Click here for the new paper in Diabetes Care and here for further perspective.
The Joy of Life, painting by Robert Delaunay / WikiArt
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March 13, 2025
March 13, 2025 at 6:49 am, Stephanie said:
I would think SGLT2is also contribute to the declines. They seem to be the ignored middle-child quietly doing a lot behind the scenes while the flashy younger child gets all the attention.
March 13, 2025 at 6:57 am, Michael Jones said:
Better tools for controlling type 2 diabetes is wonderful. However, any thoughts about why we are becoming better at treating diabetes, but worse at preventing it? The prevalence of type 2 diabetes in the US in 1995 was 4%, in 2021 it was 11.6%. Why do we seem to be putting all of our energy into treatment after a patient has the disease? Why are we not laser focused on finding insulin resistance in its earliest stages (especially for those who appear to be at greater risk (obesity, family history, etc)? Checking a fasting glucose and fasting insulin and calculating a HOMA-IR is super easy. Why is this not standard of care? I have some likely unpopular ideas about this.
March 13, 2025 at 9:35 am, Ted said:
Excellent question. Excellent answers are hard to find.
March 17, 2025 at 10:52 am, JAIME FIVECOAT said:
I would think that during that during that time frame it would be surgery having the biggest contribution to the reduction.