Diabetes
Alcohol use among Veterans with type 2 diabetes who do and do not receive GLP-1 analogs Kirsha S Gordon, PhD* Kirsha Gordon Alissa Chen, MD Cynthia A Brandt, MD James Dziura, PhD Robin M Masheb, PhD Lori Bastian, MD William C Becker, MD
Background
Glucagon like peptide-1 receptor agonists (GLPs) have demonstrated benefit in the treatment of type 2 diabetes (DM2) and obesity. Emerging data suggest an association between use of this class of agents and decreased urges for and consumption of alcohol. The purpose of this cross-sectional observational study is to examine the association between GLPs and alcohol use among a large US sample of patients in care with DM2.
Methods
Data from the Veterans Health Administration’s Corporate Data Warehouse, a national repository that contains clinical, administrative, pharmacy, and financial information was accessed through the VA Informatics and Computing Infrastructure for fiscal years 2017-2023. Veterans with DM2 (based on ICD-10 E11) were identified and their GLP receipt status (yes/no) and alcohol use (based on AUDIT-C scores, ranging from 0-12) ascertained. A negative binomial (NB) model, adjusted for demographic and clinical factors, was used to assess the relationship between receipt of GLPs and alcohol use.
Results
There were 2,142,992 patients with DM2 in care from 2017-2023 of which 12% received GLPs. Those receiving GLPs were younger (<65 years older; 50% vs. 68%), more likely to be female (8% vs. 4%) and obese (85% vs. 63%), and less likely to be Black (18% vs. 20%), compared to those not receiving GLPs. Those receiving GLPs had a lower proportion of alcohol use disorder (7% vs. 8%). In NB models, receipt of GLPs was associated with lower AUDIT-C score (prevalence ratio (95% CI )=0.781 (0.776, 0.786)). Factors associated with higher AUDIT-C score were male sex, PTSD, and substance use.
Conclusions
In a nationwide sample of patients with DM2, those receiving GLPs had 22% lower AUDIT-C score. Further work is needed to assess the association of GLP receipt on alcohol use over time.