The effect of early response to GLP-1 RA therapy on long-term adherence and persistence among type 2 diabetes patients in the United States.
Open accessAbstract
BACKGROUND: Treatment adherence and persistence are crucial to achieve glycemic control in patients with type 2 diabetes (T2D). Early response to a new therapy may lead to improved treatment adherence and associated outcomes. OBJECTIVE: To assess the effect of early response to glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy, as indicated by reduced hemoglobin A1c (A1c) and body weight, on long-term adherence and persistence. METHODS: Adults aged ≥ 18 years with T2D initiated with GLP-1 RA therapy after January 1, 2010, were identified from the IBM Explorys Therapeutic Dataset. Patients were required to have health care utilization ≥ 6 months before and ≥ 18 months after the index prescription. Changes in A1c and body weight from baseline through 6 months were assessed for all patients; early response was defined by > 1% reduction in A1c and > 3% reduction in body weight within 3-6 months. Adherence (assessed as the proportion of days covered [PDC] ≥ 80%) and nonpersistence/discontinuation (indicated by a gap in therapy ≥ 60 days) over 18 months were evaluated among early responders versus nonresponders. Multivariable logistic regression was used to assess the effect of early response to GLP-1 RA therapy on adherence and discontinuation over 18 months. RESULTS: < 0.001) of early responders discontinued over 18 months compared with patients without an early response (A1c: 61.4% vs. 67.9%; body weight: 61.9% vs. 67.5%). After controlling for baseline demographic and clinical characteristics including baseline weight, baseline A1c, oral antidiabetes drug use, insulin use, and the presence of comorbidity of diabetes, patients were more likely to be adherent over 18 months if they had reductions in A1c > 1% (OR = 1.59, 95% CI = 1.36-1.85) or body weight reduction > 3% (OR = 1.18, 95% CI = 1.02-1.36) at 3-6 months compared with those without an early response. Similarly, the early responders had significantly lower likelihood of discontinuation compared with those without early response (A1c > 1%; OR = 0.62, 95% CI = 0.53-0.72; body weight > 3%; OR = 0.81, 95% CI = 0.70-0.94). CONCLUSIONS: Early response to GLP-1 RA therapy was associated with significantly increased adherence and reduced likelihood of discontinuation. DISCLOSURES: Funding to conduct this study was provided to IBM Watson Health by Novo Nordisk A/S. The analysis was conducted independently by IBM Watson Health. Novo Nordisk A/S and IBM Watson Health collaborated on study design and interpretation of results. At the time of this study, Durden and Laing were employed by IBM Watson Health and received funding from Novo Nordisk to conduct this study. Fowler is employed by IBM Watson Health. Panton and Mocevic were employed by Novo Nordisk while this study was conducted. A portion of these results were presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2018; April 23-26, 2018; Boston, MA, where it was awarded with a bronze ribbon.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
High and widely varying rates of GLP-1 receptor agonist discontinuation at 1 year have been reported, ranging from 37% to 81%.
“High and widely varying rates of GLP-1 RA discontinuation at 1 year have been reported, ranging from 37% to 81%.20,21,22,23,24”
From Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity (2025) · cites this paper as [20]
The Results report substantial GLP-1 RA discontinuation—60.0% to 67.9% across response groups—but measure it over 18 months. The cited paper does not report the claimed 37%–81% range at one year. (LLM, conf=0.82)
Experimental — accuracy not yet measuredRecent studies have found GLP-1 RA discontinuation rates ranging from 37% to 81%, depending on the population, data source, and time period considered.
“Recent studies have found discontinuation rates ranging from 37% to 81%, depending on the population, data source, and time period considered.20,21,22,23,24,27”
From Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity (2025) · cites this paper as [20]
The high rate of GLP-1 RA discontinuation observed in this study (53.6% by 1 year) is consistent with other analyses.
“First, the high rate of GLP-1 RA discontinuation observed in this study (53.6% by 1 year) is consistent with other analyses.”
From Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity (2025) · cites this paper as [20]
An analysis of real-world data in the USA showed that modest weight loss after initiating GLP-1 RAs may increase patient adherence.
“Conversely, an analysis of real-world data in the USA showed that modest weight loss after initiating GLP-1 RAs may increase patient adherence.”
From Real-world weight change, adherence, and discontinuation among patients with type 2 diabetes initiating glucagon-like peptide-1 receptor agonists in the UK (2022) · cites this paper as [10]
The extent to which real-world patients with T2DM achieve clinically meaningful weight loss (≥5%) has not been well characterized.
“However, the extent to which real-world patients with T2DM achieve clinically meaningful weight loss (≥5%) has not been well characterized.”
From Real-world weight change, adherence, and discontinuation among patients with type 2 diabetes initiating glucagon-like peptide-1 receptor agonists in the UK (2022) · cites this paper as [10]
The Results (page unavailable) characterize weight loss in real-world patients with T2D receiving GLP-1 RA therapy using a >3% threshold. Searches for ≥5% weight loss and whether its extent was poorly characterized found no passage addressing either point. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452 · see citing works
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629 · see citing works
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
Marso, S. P., Bain, S. C., Consoli, A., Eliaschewitz, F. G., Jódar, E., Leiter, L. A., Lingvay, I., Rosenstock, J., Seufert, J., Warren, M. L., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1607141 · Cited by 6,900 · see citing works
Adherence to Therapies in Patients with Type 2 Diabetes
García‐Pérez, L., Álvarez, M., Dilla, T., Gil-Guillén, V. F., & Orozco‐Beltrán, D. (2013) · Diabetes Therapy · doi:10.1007/s13300-013-0034-y · Cited by 738 · see citing works
Bethel, M. A., Patel, R. A., Merrill, P., Lokhnygina, Y., Buse, J. B., Mentz, R. J., Pagidipati, N. J., Chan, J. C., Gustavson, S. M., Iqbal, N., et al. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30412-6 · Cited by 599 · see citing works
Clinical Outcomes and Adherence to Medications Measured by Claims Data in Patients With Diabetes
Pladevall, M., Williams, L. K., Potts, L. A., Divine, G., Xi, H., & Lafata, J. E. (2004) · Diabetes Care · doi:10.2337/diacare.27.12.2800 · Cited by 404 · see citing works
Patient Adherence Improves Glycemic Control
Rhee, M. K., Slocum, W., Ziemer, D. C., Culler, S. D., Cook, C. B., El‐Kebbi, I. M., Gallina, D. L., Barnes, C., & Phillips, L. S. (2005) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721705274927 · Cited by 339 · see citing works
Broadbent, E., Donkin, L., & Stroh, J. C. (2011) · Diabetes Care · doi:10.2337/dc10-1779 · Cited by 304 · see citing works
Achievement of Glycated Hemoglobin Goals in the US Remains Unchanged Through 2014
Carls, G., Huynh, J., Tuttle, E., Yee, J., & Edelman, S. V. (2017) · Diabetes Therapy · doi:10.1007/s13300-017-0280-5 · Cited by 228 · see citing works
The Incidence and Determinants of Primary Nonadherence With Prescribed Medication in Primary Care
Tamblyn, R. M., Eguale, T., Huang, A. R., Winslade, N. E., & Doran, P. (2014) · Annals of Internal Medicine · doi:10.7326/m13-1705 · Cited by 193 · see citing works
A Brief History of the Development of Diabetes Medications
White, J. R. (2014) · Diabetes Spectrum · doi:10.2337/diaspect.27.2.82 · Cited by 177 · see citing works
Predictors of medication adherence in patients with type 2 diabetes mellitus
Curkendall, S. M., Thomas, N., Bell, K. F., Juneau, P. L., & Weiss, A. J. (2013) · Current Medical Research and Opinion · doi:10.1185/03007995.2013.821056 · Cited by 149 · see citing works
Alatorre, C., Fernández Landó, L., Yu, M., Brown, K., Montejano, L., Juneau, P., Mody, R., & Swindle, R. (2017) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12902 · Cited by 111 · see citing works
Tran, K., Park, Y. I., Pandya, S., Muliyil, N. J., Jensen, B. D., Huynh, K., & Nguyen, Q. P. H. (2017) · PubMed Central · Cited by 102 · see citing works
15. Diabetes Advocacy: <i>Standards of Medical Care in Diabetes—2018</i>
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dc18-s015 · Cited by 97 · see citing works
Egede, L. E., Gebregziabher, M., Hunt, K. J., Axon, R. N., Echols, C. L., Gilbert, G. E., & Mauldin, P. D. (2011) · Diabetes Care · doi:10.2337/dc10-1504 · Cited by 95 · see citing works
Rike, W. A., Kassahun, A., Gashe, F., & Bobasa, E. M. (2015) · Journal of Pharmacy And Bioallied Sciences · doi:10.4103/0975-7406.171696 · Cited by 88 · see citing works
Svensson, E., Baggesen, L. M., Johnsen, S. P., Pedersen, L., Nørrelund, H., Buhl, E. S., Haase, C. L., & Thomsen, R. W. (2017) · Diabetes Care · doi:10.2337/dc16-2271 · Cited by 77 · see citing works
Nguyen, H., Dufour, R., & Caldwell-Tarr, A. (2017) · Advances in Therapy · doi:10.1007/s12325-016-0470-y · Cited by 50 · see citing works
Mody, R., Grabner, M., Yu, M. B., Turner, R., Kwan, A. Y. M., York, W., & Landó, L. F. (2017) · Current Medical Research and Opinion · doi:10.1080/03007995.2017.1421146 · Cited by 50 · see citing works
Grandy, S., Fox, K., & Hardy, É. (2013) · Current Therapeutic Research · doi:10.1016/j.curtheres.2013.06.004 · Cited by 46 · see citing works
Reach, G. (2011) · Patient Preference and Adherence · doi:10.2147/ppa.s24518 · Cited by 41 · see citing works
Wilke, T., Mueller, S., Groth, A., Berg, B., Fuchs, A., Sikirica, M., Logie, J., Martin, A., & Maywald, U. (2016) · Diabetes Therapy · doi:10.1007/s13300-015-0149-4 · Cited by 41 · see citing works
GLP-1 RA Treatment Patterns Among Type 2 Diabetes Patients in Five European Countries
Divino, V. M., DeKoven, M., Khan, F. A., Boye, K. S., Sapin, H., & Norrbacka, K. (2017) · Diabetes Therapy · doi:10.1007/s13300-016-0224-5 · Cited by 36 · see citing works
Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes
von Arx, L., Gydesen, H., & Skovlund, S. E. (2016) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2015-000166 · Cited by 29 · see citing works
McAdam‐Marx, C., Bellows, B. K., Unni, S. K., Mukherjee, J., Wygant, G. D., Iloeje, U. H., Liberman, J. N., Ye, X., Bloom, F. J., & Brixner, D. I. (2014) · International Journal of Clinical Practice · doi:10.1111/ijcp.12502 · Cited by 23 · see citing works
Early use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in Type 2 diabetes
Ross, S. A., & Ballantine, J. (2013) · Current Medical Research and Opinion · doi:10.1185/03007995.2013.837817 · Cited by 16 · see citing works
Buysman, E. K., Anderson, A. J., Bacchus, S., & Ingham, M. (2017) · Advances in Therapy · doi:10.1007/s12325-017-0500-4 · Cited by 15 · see citing works
Tong, L., Pan, C., Wang, H., Bertolini, M., Lew, E., & Meneghini, L. (2017) · Diabetes Obesity and Metabolism · doi:10.1111/dom.13156 · Cited by 14 · see citing works
In This Issue of Diabetes Care
(2017) · Diabetes Care · doi:10.2337/dc18-ti01 · Cited by 7 · see citing works
Singhal, M., Nguyen, H., Schauerhamer, M. B., Unni, S. K., Cobden, D., & McAdam‐Marx, C. (2015) · Value in Health · doi:10.1016/j.jval.2015.03.317 · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Novo Nordisk. Novo Nordisk receives FDA approval of Ozempic (sema- glutide) injection for the treatment of adults with type 2 diabetes [news release]. Available at: http://press.novonordisk-us.com/2017-12-5-Novo-Nor- disk-Receives-FDA-Approval-of-OZEMPIC-R-semaglutide-Injection-For-the- Treatment-of-Adults-with-Type-2-Diabetes. Accessed February 23, 2019.
Cited by
Sorted by citations
Rodriguez, P. J., Zhang, V., Gratzl, S., Do, D., Goodwin Cartwright, B., Baker, C., Gluckman, T. J., Stucky, N., & Emanuel, E. J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.57349 · Cited by 374 · see citing works
Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity
Rodriguez, P. J., Goodwin Cartwright, B. M., Gratzl, S., Brar, R., Baker, C., Gluckman, T. J., & Stucky, N. L. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.2525 · Cited by 334 · see citing works
Weiss, T., Yang, L., Carr, R. D., Pal, S., Sawhney, B., Boggs, R., Rajpathak, S., & Iglay, K. (2022) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2021-002517 · Cited by 152 · see citing works
Evans, M., Engberg, S., Faurby, M. D., Fernandes, J. D. D. R., Hudson, P., & Polonsky, W. H. (2021) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14603 · Cited by 91 · see citing works
Adherence and persistence rates of major antidiabetic medications: a review
Lee, D. S. U., & Lee, H. (2022) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-022-00785-1 · Cited by 72 · see citing works
Palanca, A., Ampudia-Blasco, F. J., Calderón, J. M., Sauri, I., Martinez-Hervás, S., Trillo, J. L., Redón, J., & Real, J. T. (2023) · Diabetes Therapy · doi:10.1007/s13300-023-01382-9 · Cited by 48 · see citing works
Determinants of adherence to obesity medication: A narrative review
Sharma, A. M., Birney, S., Crotty, M., Finer, N., Segal‐Lieberman, G., Vázquez‐Velázquez, V., & Vrijens, B. (2025) · Obesity Reviews · doi:10.1111/obr.13885 · Cited by 36 · see citing works
Porto, J. R., Lavu, M. S., Hecht, C. J., Kaelber, D. C., Sculco, P. K., Heckmann, N. D., & Kamath, A. F. (2025) · Orthopaedic Journal of Sports Medicine · doi:10.1177/23259671241297157 · Cited by 32 · see citing works
Tang, A. S. P., Hsu, J. T. Y., Chong, S. K. S., Quek, J., Shek, G., Sulaimi, F., Chan, K. E., Anand, V. V., Chong, B., Mehta, A., et al. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02840-3 · Cited by 26 · see citing works
Alexopoulos, A., & Buse, J. B. (2019) · Metabolism · doi:10.1016/j.metabol.2019.06.012 · Cited by 24 · see citing works
Scragg, J., Koutoukidis, D. A., Dirksen, C., Heitmann, B. L., & Jebb, S. A. (2025) · Med · doi:10.1016/j.medj.2025.100805 · Cited by 16 · see citing works
Boye, K. S., Shinde, S., Kennedy-Martin, T., Robinson, S., & Thieu, V. T. (2022) · Patient Preference and Adherence · doi:10.2147/ppa.s328583 · Cited by 15 · see citing works
Boye, K. S., Shinde, S., Kennedy‐Martin, T., Robinson, S. J., & Thieu, V. T. (2022) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 14 · see citing works
Ciardullo, S., Savaré, L., Rea, F., Perseghin, G., & Corrao, G. (2024) · Diabetes/Metabolism Research Reviews · doi:10.1002/dmrr.3791 · Cited by 12 · see citing works
Kim, H. S., Cho, Y. K., Kim, M., Jung, C. H., Park, J., & Lee, W. J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1032793 · Cited by 11 · see citing works
Guerci, B., Giorgino, F., Sapin, H., Boye, K. S., Lebrec, J., Federici, M. O., Heitmann, E., Dib, A., Füchtenbusch, M., & García‐Pérez, L. (2022) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14823 · Cited by 10 · see citing works
Sims, T. J., Boye, K. S., Robinson, S. J., & Kennedy‐Martin, T. (2022) · Patient Preference and Adherence · doi:10.2147/ppa.s367046 · Cited by 7 · see citing works
Rodriguez, P. J., Zhang, V., Gratzl, S., Do, D., Cartwright, B. M. G., Baker, C., Gluckman, T. J., Stucky, N. L., & Emanuel, E. J. (2024) · medRxiv · doi:10.1101/2024.07.26.24311058 · Cited by 5 · see citing works
Inceu, G. V., Crăciun, A.-E., Ciobanu, D. M., Berchisan, A., Fodor, A., Bala, C., Roman, G., & Rusu, A. (2025) · Medicina · doi:10.3390/medicina61081343 · Cited by 3 · see citing works
Heisey, H. D., Gregg, L. P., Verrico, C. D., Villareal, D. T., & Fletcher, T. L. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70913 · Cited by 3 · see citing works
Romera, I., Conget, I., Vázquez, L. A., Gentilella, R., Lebrec, J., Jódar, E., & Reviriego, J. (2020) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2020.107575 · Cited by 3 · see citing works
Factors contributing to non-persistence of glucagon-like peptide-1 agonists: a cross-sectional study
Liu, S., Wong, G., Mavi, P., Gysel, S. C., Burton, D., Monteiro, N., Durocher, D., Sharma, A. M., & Tsuyuki, R. T. (2025) · Obesity Medicine · doi:10.1016/j.obmed.2025.100674 · Cited by 2 · see citing works
Mai, Z., Kornak, J., Dufault, S. M., Strand, M. W., Reikes, A., & Watanabe, J. H. (2025) · Annals of Pharmacotherapy · doi:10.1177/10600280251384637 · Cited by 2 · see citing works
Wang, Y., Stofer, R., Wang, H., Cai, Y. C., Brent, G. A., Moin, T., & Shi, L. (2025) · Research Square · doi:10.21203/rs.3.rs-6586064/v1 · Cited by 1 · see citing works
Ahangarian, Z., Kafaei-Atrian, M., Afshar, M., & Sadat, Z. (2022) · International Archives of Health Sciences · doi:10.4103/iahs.iahs_200_21
Lee, D., & Lee, H. (2023) · Journal of Diabetes Research · doi:10.1155/2023/7917641
Pollmann, D. L., Parry, J., Cravero, E., Benson, G. A., Sanchez, O. A., White, S., Stanberry, L. I., Wambach, C., & Miedema, M. D. (2025) · medRxiv · doi:10.1101/2025.08.01.25332846
Akerman, N., Isakov, N. F., Thurm, T., Shnell, M., Sofer, Y., Shibolet, O., & Deutsch, L. (2025) · Therapeutic Advances in Gastrointestinal Endoscopy · doi:10.1177/26317745251359459
Sanzen, K., Salganik, N. S., Campbell, S. D., Karner, C. A., Yeracaris, P., & Kogut, S. J. (2026) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.70171
Barthold, D., Zissimopoulos, J., Basu, A., & Tysinger, B. (2026) · Alzheimer s & Dementia · doi:10.1002/alz.71794
- Authors
- Durden, E., Liang, M., Fowler, R., Panton, U. H., & Mocevic, E.
- Affiliations
- IBM (United States) (US)
- Novo Nordisk (Denmark) (DK)
- ORCID
- Durden, Emily
- Venue
- Journal of Managed Care & Specialty Pharmacy
- Publisher
- Academy of Managed Care Pharmacy
- Published
- 2019-06
- Volume
- 25
- Issue
- 6
- Pages
- 669-680
- ISSN
- 2376-0540 (ISSN-L)
- 2376-1032
- PMC
- PMC10397904
- OpenAlex
- W2923688702
- Cited by
- 30
- References
- 30
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 1 · 2020: 1 · 2019: 1
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Managed Care & Specialty Pharmacy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, GLP-1 receptor agonists, medication adherence, treatment persistence, early treatment response, weight loss, proportion of days covered, drug discontinuation, glycemic control, health care utilization, real-world evidence, United States patients, health care costs
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Aged, Body Weight, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Middle Aged, Retrospective Studies, Time Factors, United States, Treatment Outcome, Drug Monitoring
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
