GLP-1 Evidence

Not medical advice. A record of published research and our assessments of it. The limits

A retrospective cohort study on the comparative safety of glucagon-like peptide-1 receptor agonists versus dipeptidyl peptidase-4 inhibitors on the onset of gallbladder disease in type II diabetes

Design
Retrospective cohort · Hard outcome
Match to healthy normal-weight adults aged 55–75
Population unclear[Auto] Population characteristics not extractable from abstract (age/BMI not reported in abstract). Needs manual review.
Could weight loss explain it?
Unknown[Auto] Not addressed in abstract.
Study tier
Study tier 3[Auto] Observational design; confounding by indication and healthy-user effects cannot be excluded (auto-provisional).
Assessment
Version 1 · automatic, not yet reviewed by a person · Sep 13, 2026

Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.

[Auto, unreviewed; quoted from abstract conclusions] A moderate but significant increase in the risk of gallbladder disease was confirmed from the real-world population receiving GLP‑1 RA compared with DPP‑4I. This confirmed risk underscores the need for ongoing monitoring and surveillance for gallbladder disease during GLP‑1RA therapy.

01Findings

What the study reported

Drugs
Class unspecified
Comparator
dipeptidyl peptidase-4 inhibitors
Primary outcome
Not extracted
Effect
Not extracted
95% confidence interval
Not extracted
Follow-up
2 years
Adverse events
Not extracted
Limitations
Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.

Who was studied

Diabetes status
diabetes mentioned

Study quality details

Study design
Retrospective cohort
Sample size
not extracted
Randomization
no
Blinding
not stated
Comparator
not stated
Follow up duration
2 years
Outcome type
hard
Replication
not assessed (auto)
Consistency with other evidence
not assessed (auto)
Population applicability
UNKNOWN
Statistical precision
CI reported: 95% CI
Risk of bias
not assessed (auto)
Funding conflicts
unclear
Peer review status
yes
02Funding

Funding and conflicts

Funding
not reported in abstract
Industry funded
Unclear
Manufacturer
None identified
Sponsor role
not reported in abstract
Author conflicts
not available in metadata
Independent replication
unknown

Funding is shown on every study and never used to score it.

04Source

The source, as retrieved

Abstract

[BACKGROUNDS AND OBJECTIVES] To assess and confirm the risk of gallbladder disease in Type II diabetes (T2D) patients treated with Glucagon-Like Peptide 1 Receptor Agonist (GLP-1RA) compared to Dipeptidyl Peptidase-4 Inhibitor (DPP-4I). [MATERIALS AND METHODS] This is a retrospective cohort study using administrative claims. Adults who newly received either GLP-1RA or DPP-4I for T2D management were identified between 2016 and 2021. Study cohort included individuals naïve to gallbladder disease or relevant condition on or 6-month prior to the first GLP-1RA or DDP-4I dispensing date (Index). Cumulative incidence of gallbladder disease after the minimal follow-up period of the first 45 days was estimated using the Kaplan-Meier method. A Cox proportional hazard regression model was used to calculate hazard ratios of gallbladder disease for GLP-1RA vs. DPP-4I up to 2 years beyond the initial 45-day exposure. [RESULTS] The cohort included 135,197 GLP-1RA and 118,919 DPP-4I patients with minor diabetes complication profiles. Cumulative incidence of gallbladder disease at 1 year was 1.286% (GLP-1RA) vs. 1.054% (DPP-4I); at 2 years, it was 2.181% vs. 2.039%. Adjusting for the baseline characteristics, the respective HR (95% CI) was 1.241 (95% CI, 1.104-1.393) at 1 year and 1.176 (95% CI, 1.061-1.304) at 2 years. [CONCLUSION] A moderate but significant increase in the risk of gallbladder disease was confirmed from the real-world population receiving GLP‑1 RA compared with DPP‑4I. This confirmed risk underscores the need for ongoing monitoring and surveillance for gallbladder disease during GLP‑1RA therapy.

Where this record came from

SourceRetrievedIdentifier
pubmedSep 13, 202642712138
first ingestion