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June 12, 2026Diabetes

Compared to prevalent metformin users, GLP-1 RA users had a lower risk of SI/SB (HR: 0.11, 95% CI 0.02 to 0.86) and depression (HR: 0.37, 95% CI 0.17 to 0.78), with no difference in anxiety risk (HR: 1.13, 95% CI 0.69 to 1.84).

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Why the study?

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 <18 years with obesity or youth-onset type 2 diabetes and no prior…

Comparison

GLP-1 receptor agonists (new users) vs Metformin (prevalent users)

Design

Cohort

Follow-up

up to 4 years

Authors

PKPareeta KotechaYLYao An LeeABAngelina Bernier

Discussion

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Overview

May not yet change prescribing in youth with diabetes; leaves open causality and needs randomized confirmation.

Key Points

  • This study assesses the impact of GLP-1 receptor agonist use on suicidal ideation, depression, and anxiety in youth with obesity or type 2 diabetes.
  • Retrospective cohort study using electronic health records from January 2020 to January 2024.
  • Compared new users of GLP-1 receptor agonists with prevalent users of metformin.
  • Employed stabilized inverse probability of treatment weighting and Cox proportional hazards models for analysis.
  • GLP-1 receptor agonist users had lower rates of suicidal ideation/behavior (RD: -10.45; HR: 0.11) and depression (RD: -25.64; HR: 0.37) compared to metformin users.
  • No significant difference in anxiety risk was found between GLP-1 RA and metformin users (RD: 5.95; HR: 1.13).

Structured PICO

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?

P
Population
Children and adolescents aged 6 to <18 years with obesity or youth-onset type 2 diabetes (YT2D) and no prior history of the outcomes of interest at baseline. N=2,010 for SI/SB cohort, 1,774 for depression, and 1,764 for anxiety. Mean age ~14.2 years, ~61% female.
I
Intervention
GLP-1 receptor agonists (new users)
C
Comparator
Metformin (prevalent users)
O
Outcome
Incidence of suicidal ideation or behavior (SI/SB), depression, and anxietysafety

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.

Cite This Study

Kotecha et al. (2026) studied this question.

synapsesocial.com/papers/6a2bd1386550ea4541ffe92dhttps://doi.org/10.2337/db26-2069-p
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