GLP-1 Medications May Outperform Metformin in Preventing Diabetes and Heart Risks, Study Finds

A large, independent study presented at the American Heart Association's Scientific Sessions 2026 indicates that GLP-1 medications may offer significant advantages over the standard diabetes prevention drug metformin for adults with prediabetes and obesity. The research, which reviewed health records for more than 250,000 adults, found that those taking GLP-1 medications were about 1.5 times more likely to reverse their blood sugar to normal levels compared to those taking metformin. The findings were announced via NEWMEDIAWIRE and highlight a potential shift in how prediabetes is managed.

The study, led by Dr. Vinicius de Sousa Barzon Serra, a research fellow at the Mayo Clinic in Scottsdale, Arizona, is among the largest to evaluate GLP-1 medications against metformin in the prediabetes stage. 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 these adults progress to Type 2 diabetes each year. "The great news with prediabetes is that it's still possible to reverse the progression of the disease," Serra said. "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."

Compared to metformin, participants taking GLP-1 medications 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. GLP-1 use was also associated with 15% fewer heart attacks, 20% fewer strokes, 25% fewer cases of heart failure, and 8% fewer cases of atrial fibrillation. These findings could influence shared decision-making between doctors and patients. "Metformin is still a first-line treatment choice. It is safe, inexpensive and has a long track record," Serra noted. "This is less about replacing one medication with another and more about discussing additional options with specific patients."

The study analyzed electronic health records from the TriNetX global network, covering 104 institutions from 2010 to 2023, with patients followed for an average of roughly three years. While the research is observational and cannot prove cause-and-effect, it adds to the growing body of evidence on GLP-1 medications. The full abstract and the Online Program Planner for Scientific Sessions 2026 are available for further details.

For Texas, a state with a large and growing population at risk for diabetes and cardiovascular disease, these findings could have significant implications for healthcare providers and employers. With nearly 40% of U.S. adults having prediabetes, earlier intervention with GLP-1 medications could reduce the long-term burden on the healthcare system and improve workforce health. The American Heart Association has previously highlighted related issues, such as in its release New guideline reframes weight as health risk tied to diabetes, kidney and heart conditions and Healthy lifestyle combined with newer diabetes medications lowered cardiovascular risk. As businesses in Texas consider healthcare costs and employee wellness, this research may prompt discussions about coverage and access to newer medications.

However, cost and access remain important factors. American Heart Association past volunteer President Robert Eckel, M.D., FAHA, noted that the benefits likely relate to weight loss and that GLP-1s provide another prevention option, perhaps as an add-on therapy. The study's limitations include its observational nature and reliance on diagnosis codes and prescription records. The findings are considered preliminary until published in a peer-reviewed journal. For more information on prediabetes and obesity, resources are available at prediabetes and obesity.