People prescribed GLP-1 drugs are more likely to start and stop than most people think, according to a study presented Sunday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, Ill.
Our study asked two questions that have not been well answered until now: How many people with type 2 diabetes who take GLP-1 drugs actually stop using them? And how many start again?”
Sainikhil Sontha, MS, research associate, Boston University School of Public Health, Boston, Mass.
The researchers conducted a retrospective cohort study using Komodo Health US claims data (January 2019 to June 2025). The cohort included adults aged 18 to 64 years with a BMI ≥25 kg/m² and type 2 diabetes who started liraglutide, semaglutide, or tirzepatide and were previously enrolled in the last year with more than 6 months of follow-up.
Discontinuation was defined as having a gap of more than 60 days in filling GLP-1 prescriptions. Receiving a new fill after the interruption was considered a restart.
“Using insurance records from more than 60,000 Americans with type 2 diabetes, we found that about 4 in 10 patients discontinued their GLP-1 medication within the first year, and nearly 6 in 10 stopped by the end of two years,” Sontha said.
But they also found something encouraging.
“More than half of those who stopped resumed treatment within one year (41.5%) and nearly two-thirds did so within two years (58%),” said Sontha. “This suggests that for many patients, these drugs are not permanently abandoned; use is more on and off than most people assumed.”
Using Cox proportional hazards models, they also accounted for sociodemographic, clinical, and provider-level prognostic factors.
Sontha and colleagues found that those receiving Medicaid or Medicare, black patients, and those experiencing nausea or other stomach-related side effects (37%) were more likely to discontinue a GLP-1 drug within a year.
People were 10% less likely to stop if their first GLP-1 drug was prescribed by an endocrinologist.
In addition, people taking newer drugs such as tirzepatide were 41% less likely to stop treatment than those taking older drugs such as liraglutide. Semaglutide users were 28% less likely to stop using anti-obesity drugs than those taking older drugs.
“This research is important because it is the consistent use of these drugs that produces their protective effects,” Sontha said. “Stopping early can mean missed opportunities to prevent heart attacks, progression of kidney disease and other complications.”
The researchers hope these findings give providers, insurers and policymakers an idea of which patients need more support to stay on GLP-1 drugs, he said.
