At the upcoming American Heart Association meeting, participants will learn of the epidemiological results of 63,656 military veterans with Type 2 diabetes in the Million Veteran Program who took GLP-1 receptor agonists (semaglutide - "Wegovy", dulaglutide - "Trulicity", etc.). The survey analysis found that those who also changed their lifestyle habits had a 50% lower risk of serious cardiovascular events(1) compared to those who didn't report a healthier lifestyle and received diabetes care without GLP-1 RA medication.
Type 2 diabetes is overwhelmingly a lifestyle disease, and obesity is third on the list of preventable lifestyle diseases, behind only alcohol and cigarettes in mortality. It has doubled in the United States this century. Many instances of Type 2 diabetes, unlike Type 1, are preventable and even reversible. It is often the case that insulin production once worked fine but became overtaxed due to food consumption. The struggle for those with it is that dieting is a challenge. If you overeat for four years you have to reduce calories by the same amount for four years, and eating too much is far easier than cutting back.
GLP-1 RA medications are a scientific shortcut. They lower blood sugar to treat diabetes but many people now use them because they also reduce appetite. You won't want to eat so if you can break the psychological habits (movies mean eating popcorn, every positive event in life means DoorDash, etc.) weight loss is a breeze. If people couple medication with other behavioral changes - exercise more - the benefits are clear, according to the survey data.
People who made dramatic changes, like losing weight, giving up cigarettes and alcohol, and exercising, plus GLP-1 medications had a 63% lower risk of a heart attack or stroke but the medicine was linked to a 20% lower risk.
Like all epidemiology, these results are EXPLORATORY. The field is under fire for decades of "linking" weedkillers to cancer, vaccines to autism, and processed foods to obesity, but has become truly controversial now because a chief evangelist, former Natural Resources Defense Council lawyer Robert F. Kennedy, Jr., got control of the National Institutes of Health. The National Institute of Environmental Health Sciences and National Center for Complementary and Integrative Health are thrilled at having one of their own in charge, but scientists who had stayed silent from the time President Clinton diverted science funding to bizarre correlation efforts until this year are alarmed.
Yet the science is clear that eating too many calories is the one sure way to gain weight, and obesity is the one sure way to get Type 2 Diabetes. If spending money now on diet injections will help, the cost savings for government health care in the future will be enormous.
NOTE:
(1) 6,191 people had a major cardiac event during the 418,513 person-years of data included in the data from 2011 to 2023 that the authors analyzed.