Study Explores the Survival Advantage of GLP-1s in Cancer Patients With Diabetes

Glucagon-like-peptide-1 receptor agonists (GLP-1) are being explored in oncology due to their positive effects on glucose, body fat, insulin resistance, and inflammation, all of which influence cancer progression. While the impact of other glucose-lowering drugs on cancer survival is mixed, newer agents like sodium-glucose cotransporter-2 (SGLT2) inhibitors have been reported to improve survival compared to DPP4 inhibitors. Although GLP-1s have been linked to a lower incidence of some cancers, their effect on survival in cancer patients with type 2 diabetes (T2D) is unclear. In a retrospective cohort study published by investigators in JAMA Network, researchers evaluated whether the use of GLP-1s is linked with improved survival among individuals with cancer and T2D.¹

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Diabetes and Cancer

According to the CDC, nearly 1 in 5 individuals with cancer also have diabetes. Individuals with diabetes who are newly diagnosed with cancer could experience disrupted diabetes management and eating plans. Cancer treatments, such as chemotherapy, radiation therapy, and hormone therapy, can significantly impact a patient’s ability to manage their blood sugar. Chemotherapy, while effective at targeting cancer cells, can harm healthy cells, leading to side effects, such as mouth sores, nausea, vomiting, and loss of appetite, which in turn can make eating difficult and potentially cause low blood sugar. Radiation therapy, which uses high-energy rays to kill cancer cells, can cause the body to release excess sugar, leading to a spike in blood sugar, and may also cause fatigue that interferes with meal and activity plans. Hormone therapy, commonly used for prostate and breast cancer, can cause nausea and fatigue, which makes it difficult to maintain proper nutrition and stay active. Additionally, other medications, such as steroids, that are commonly administered with chemotherapy to combat nausea, can directly raise blood sugar levels.²

Despite the challenges, effective diabetes management remains crucial during cancer treatment, and remaining in control of blood sugar can help reduce the risk of infections and benefit the overall cancer treatment outcomes. The CDC recommends individuals try eating a balanced meal plan on days that they feel well enough, including foods that are higher in calories or protein but are still healthy, foods that improve appetite, and foods that are enjoyable.²

GLP-1s Use in Diabetes and Cancer

Researchers conducted a retrospective cohort using Medicare data from 2013 to 2020 to evaluate the connection between GLP-1s and all-cause mortality in individuals with T2D and cancer. Included individuals were aged 66 years and older, with T2D and 1 of 9 cancers—thyroid, pancreatic, bladder, colorectal, lung, kidney, breast, endometrial, or prostate.¹

In the cohort comparing GLP-1s with SGLT2 inhibitors, a total of 2553 matched pairs were involved with a median follow-up of 1.65 years from first drug prescription. In the other cohort comparing dipeptidyl peptidase-4 (DPP4) inhibitors, a total of 2564 matched pairs were included with a median follow-up of 1.7 years.¹

The results demonstrated that among older patients with cancer and T2D, GLP-1 use was linked to lower all-cause mortality compared to DPP4 inhibitor use and showed no significant difference when compared to SGLT2 inhibitors. The survival advantage over DPP4 inhibitors was consistent across demographics, including age, sex, non-Hispanic White individuals, obesity status, and several cancers like colorectal, lung, and breast cancer. The study authors noted that although a recent study indicated that the impact of GLP-1 expression on survival varies by cancer type, this study provides new evidence on the comparative effectiveness of GLP-1s.¹

However, this current study has limitations, including potential confounding factors and some underpowered subgroup analyses, emphasizing the need for clinical trials to confirm the role of GLP-1s in cancer survivorship.¹

REFERENCES

1. Radwan RM, Lu Y, Dai H, et al. GLP-1 RA Use and Survival Among Older Adults With Cancer and Type 2 Diabetes. JAMA Netw Open. 2025;8(7):e2521887. doi:10.1001/jamanetworkopen.2025.21887

2. CDC. I Have Diabetes and Cancer. What Can I Eat? News release. May 15, 2024. Accessed July 25, 2025. https://www.cdc.gov/diabetes/healthy-eating/diabetes-and-cancer-what-to-eat.html