Why the study?
Increasing GLP-1 receptor agonist use among children and adolescents with obesity or youth-onset type 2 diabetes has raised concerns regarding potential risks of suicidal ideation or behaviors, depression, and anxiety.
Does GLP-1 RA use reduce the risk of suicidal ideation/behaviors, depression, and anxiety in children and adolescents with obesity or youth-onset type 2 diabetes compared to metformin?
Population
Children and adolescents aged 6 to younger than 18 years with obesity or YT2D
Comparison
New users of GLP-1 RAs vs prevalent users of metformin
Design
Retrospective cohort study using a target trial emulation approach
Follow-up
Up to 4 years
Key result
GLP-1 receptor agonist use in children and adolescents with obesity or type 2 diabetes was associated with a lower risk of suicidal ideation or behaviors than metformin (HR 0.11; 95% CI 0.02-0.86).
Authors
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May not yet change prescribing in youth with diabetes; leaves open causality and needs randomized confirmation.
Cohort (n=2,010)
Yes
Does GLP-1 RA use reduce the risk of suicidal ideation/behaviors, depression, and anxiety in children and adolescents with obesity or youth-onset type 2 diabetes compared to metformin?
Hazard Ratio: 0.11 (95% CI 0.02–0.86)
In children and adolescents with obesity or type 2 diabetes, GLP-1 receptor agonist use is associated with a significantly lower risk of suicidal ideation/behaviors and depression compared to metformin use.
Kotecha et al. (2026) conducted a cohort in Obesity or youth-onset type 2 diabetes (n=2,010). GLP-1 receptor agonists vs. Metformin was evaluated on Suicidal ideation or behavior (SI/SB) (HR 0.11, 95% CI 0.02 to 0.86). GLP-1 receptor agonist use in children and adolescents with obesity or type 2 diabetes was associated with a lower risk of suicidal ideation or behaviors than metformin (HR 0.11; 95% CI 0.02-0.86).
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