Cancer Survivors With Diabetes Less Likely to Use Injectable GLP-1 RAs

Adults with diabetes and a history of cancer were less likely than those without a cancer history to report current use of injectable glucagon-like peptide-1 receptor agonists (GLP-1 RAs), according to a research letter published in JAMA Network Open.

Investigators from the Huntsman Cancer Institute, University of Utah, and colleagues noted that GLP-1 RAs improve glycemic control and reduce cardiovascular and kidney risk in adults with type 2 diabetes, and that cancer therapies are associated with elevated cardiometabolic and kidney risk.

The cross-sectional study used 2024 National Health Interview Survey data on 3,615 adults with self-reported diagnosed diabetes, representing 26.4 million US adults. Of these, 674 reported a history of cancer other than nonmelanoma skin cancer alone. Unadjusted current injectable GLP-1 RA use was 20.0% among cancer survivors and 27.9% among adults without a cancer history. After adjustment for demographic, socioeconomic, and clinical factors, cancer survivors had about 30% lower odds of current use (adjusted odds ratio [aOR], 0.70; 95% CI, 0.52-0.96).

Cancer survivors were older and had higher prevalences of atherosclerotic cardiovascular disease (33.8% vs 23.6%) and chronic kidney disease (19.8% vs 10.9%). Insurance type modified the association, with adjusted differences of −5.0 percentage points among privately insured adults and −3.0 percentage points among Medicare beneficiaries. In a prespecified sensitivity analysis limited to adults with type 2 diabetes, the estimate pointed in the same direction but was not statistically significant (aOR, 0.80; 95% CI, 0.58-1.10).

The authors noted that the available data do not explain the difference or show whether treatment was clinically appropriate. Reported limitations include the cross-sectional design; self-reported diabetes, cancer history, and medication use; no capture of oral GLP-1 RA use; and a lack of data on contraindications, formulary coverage, and clinical eligibility. The investigators said longitudinal studies are needed to determine whether the differences reflect eligibility, prescribing practices, patient preferences, treatment priorities, or health system factors.

Source: Linares-Perdomo O, Klebe D, Chino F, Odei BC. GLP-1 receptor agonist use among adults with diabetes and cancer history. JAMA Netw Open. 2026;9(10):e2637813. doi:10.1001/jamanetworkopen.2026.37813