Diabetes and Cardiovascular Disease

A new observational study from Washington University School of Medicine in St. Louis, published in BMJ Medicine, finds that people with type 2 diabetes who stop GLP‑1 receptor agonists such as semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) rapidly lose much of the cardiovascular protection those drugs provide. Tracking more than 333,000 U.S. veterans over about three years and comparing GLP‑1 use to sulfonylurea diabetes pills, researchers found that three years of continuous GLP‑1 therapy was associated with an 18% reduction in combined risk of heart attack, stroke and death. But after stopping GLP‑1s, that benefit eroded quickly, with cardiovascular risk rising 4% after six months off the drug, 14% after one year, and 22% after two years, and restarting therapy only partially restored the benefit to about a 12% reduction. Lead author Ziad Al‑Aly warned that protection that takes years to build can "vanish in a few months" after discontinuation and that cycling on and off these medications may leave a lasting "scar" on heart risk. The findings reinforce concerns raised by cardiologists that these blockbuster weight‑loss and diabetes drugs likely need to be treated as long‑term, chronic‑disease medications rather than short‑term fixes, with implications for insurance coverage, patient expectations and ongoing debates over their cost and side‑effect profiles.