Sleep Breath. 2026 Jun 27;30(4):199. doi: 10.1007/s11325-026-03748-2.
ABSTRACT
PURPOSE: Tirzepatide, a GLP-1 receptor agonist (GLP-1RA), is the first approved medication for the treatment of moderate to severe OSA and has previously been found to reduce cardiovascular risks in patients with type 2 diabetes mellitus (T2DM). Our study analyzed the effects of GLP-1RA in preventing cardiovascular and pulmonary complications in patients with OSA and T2DM during a 5-year follow-up period.
METHODS: Through the TriNetX database, patients with OSA and T2DM from 2010-2022 were included. We compared patients receiving GLP-1RA versus other diabetic medications including metformin, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylurea, and thiazolidinedione. Using a propensity score model, participants were matched on a range of demographic and clinical factors. Patients were evaluated for cardiovascular and pulmonary outcomes using a Kaplan-Meier survival analysis. We additionally analyzed the incidence rate of ED visits and inpatient admissions.
RESULTS: After matching, 5,750 to 21,065 patients were included in the GLP-1RA versus other diabetes medication groups. GLP-1RA showed a lower risk of acute respiratory failure compared to metformin (HR 0.89; 95%CI 0.80-0.98), DPP-4 inhibitors (HR 0.78; 95%CI 0.71-0.85), sulfonylureas (HR 0.70; 95%CI 0.64-0.76) and TZD (HR 0.76; 95%CI 0.65-0.89). GLP-1RA group demonstrated significantly lower risk of pulmonary hypertension, chronic obstructive pulmonary disease (COPD), and heart failure when compared to DPP-4 inhibitors, sulfonylureas, and TZD.
CONCLUSION: GLP-1RA use was associated with a lower risk of pulmonary complications including acute respiratory failure, pulmonary hypertension, and COPD as well as lower ED visits and inpatient admissions compared to other diabetes medications. Further prospective studies are needed to evaluate the benefits of GLP-1RA.
PMID:42363996 | DOI:10.1007/s11325-026-03748-2