The Effect of GLP-1RAs in Diabetic Retinopathy

Real-world studies present mixed evidence on the link between GLP-1RA use and DR progression.

By: Julia H. Joo, MD, MPH, Aleksandra V. Rachitskaya, MD, FASRS

Retinal Physician June 1, 2025 Vol 22, Issue June 2025 Page(s): 6-9

5 Key Takeaways

1

GLP-1 receptor agonists (GLP-1RAs) are effective for diabetes management but raise concerns about diabetic retinopathy (DR) progression.
2

SUSTAIN 6 trial indicated a higher risk of DR complications in semaglutide users, prompting FDA warnings regarding GLP-1RAs.
3

Meta-analyses show mixed results on GLP-1RAs and DR, with some studies linking rapid HbA1c reduction to increased DR complications.
4

Real-world studies present conflicting evidence on GLP-1RAs and DR, highlighting the need for standardized reporting and definitions.
5

Some large database studies found no significant association between GLP-1RAs and DR, emphasizing variability in outcomes based on control groups.

Julia H. Joo

Specialties: Diabetic retinopathy

Bio: Julia H. Joo, MD, MPH, is an author in Retinal Physician writing on retina-related topics, including diabetic retinopathy. Her work has addressed the clinical evidence surrounding glucagon-like peptide-1 receptor agonists and diabetic retinopathy progression.

Aleksandra V. Rachitskaya

Specialties: Retina / diabetic retinopathy

Bio: Aleksandra V. Rachitskaya, MD, FASRS, writes on retinal disease, including diabetic retinopathy. Her work in Retinal Physician has addressed the clinical evidence around glucagon-like peptide 1 receptor agonists and diabetic retinopathy progression, including safety concerns raised by clinical trial and real-world data.

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Retinal Physician

The Effect of GLP-1RAs in Diabetic Retinopathy

5 Key Takeaways

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