Kassem S, Khalaila B, Stein N, Zaina A. Glucagon-like peptide 1 receptor agonists switching patterns in type two diabetes: A retrospective real-world study. World J Diabetes 2025; 16(11): 112999 [DOI: 10.4239/wjd.v16.i11.112999]
Corresponding Author of This Article
Sameer Kassem, MD, Head, Department of Internal Medicine, Technion Israel Institute of Technology, Michal 7, Haifa 3436212, Israel. sameerk@technion.ac.il
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 14, 2025
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Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Diabetes
ISSN
1948-9358
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Kassem S, Khalaila B, Stein N, Zaina A. Glucagon-like peptide 1 receptor agonists switching patterns in type two diabetes: A retrospective real-world study. World J Diabetes 2025; 16(11): 112999 [DOI: 10.4239/wjd.v16.i11.112999]
Sameer Kassem, Department of Internal Medicine, Technion Israel Institute of Technology, Haifa 3436212, Israel
Buthaina Khalaila, Department of Pharmacology, Clalit Health Services, Haifa 3436212, Israel
Nili Stein, Department of Epidemiology, Clalit Health Services, Haifa 3436212, Israel
Adnan Zaina, Department of Endocrinology, Bar Ilan University, Haifa 3436212, Israel
Author contributions: Kassem S designed the research, wrote the original draft, edited, and revised the subsequent versions of the manuscript; Khalaila B investigated the data; Stein N investigated the data and performed the statistical analyses; Zaina A participated in writing the original draft; All authors approved the final version of the manuscript.
Institutional review board statement: Ethical approval for this study was obtained from the Carmel Medical Center Institutional Review Board, in accordance with the Declaration of Helsinki, No. CMC-0048-21.
Informed consent statement: Since this study involves retrospective analysis of anonymized data, obtaining informed consent is not applicable.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: The data supporting this study's findings are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sameer Kassem, MD, Head, Department of Internal Medicine, Technion Israel Institute of Technology, Michal 7, Haifa 3436212, Israel. sameerk@technion.ac.il
Received: August 12, 2025 Revised: September 14, 2025 Accepted: October 20, 2025 Published online: November 15, 2025 Processing time: 94 Days and 11.8 Hours
Abstract
BACKGROUND
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) play a key role in managing type 2 diabetes mellitus (T2DM). Transitioning between different GLP-1RA has been proposed as a treatment strategy.
AIM
To investigate switching patterns between GLP-1RA and their impact on glycemic control.
METHODS
A retrospective study involving patients with T2DM who initiated GLP-1RA therapy between 2009 and 2021 and transitioned to another GLP-1RA. Baseline glycated hemoglobin (HbA1c) was defined as the most recent measurement within 1 year prior to switching, and follow-up HbA1c was the first measurement recorded 4-15 months post-switch.
RESULTS
Among 70654 patients initiating GLP-1RA therapy, 18047 (25.5%) switched regimens. In the 13970 patients with available HbA1c, levels decreased from 8.5% ± 1.6% to 7.6% ± 1.4% (P < 0.001). HbA1c decreased in 78.3% (10943/13970) of these patients, with the most frequent improvement observed in those switching from daily to weekly GLP-1RA (81%, 5582/6890).
CONCLUSION
Switching between GLP-1RAs can serve as a practical alternative to treatment intensification for effectively managing T2DM.
Core Tip: This retrospective study analyzed the effects of switching between glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes mellitus. It found that 25.5% of over 70000 patients changed GLP-1RA regimens, with most experiencing significant glycated hemoglobin reductions, from 8.5% to 7.6%. Notably, switching from daily to weekly GLP-1RA was associated with the highest improvement rate (81%), demonstrating that such transitions are a practical and effective alternative to treatment intensification for better glycemic control.
