Patients with type 2 diabetes mellitus (T2DM) prescribed glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have significantly lower one-year mortality, especially those also diagnosed with obstructive sleep apnea (OSA), according to a study presented at CHEST 2025, the annual meeting of the American College of Chest Physicians, held from Oct. 19 to 22 in Chicago.

Cosmo Fowler, M.D., from Emory University in Atlanta, and colleagues examined data from the TriNetX U.S. Collaborative Network to examine whether OSA modifies outcomes in patients with T2DM receiving GLP-1 RAs.

A total of 1,799,261 patients with T2DM who were prescribed metformin were identified and stratified into T2DM without OSA prescribed metformin without GLP-1 RAs (60.2%); T2DM without OSA prescribed metformin and GLP-1 RAs (20.1%); T2DM with OSA prescribed metformin without GLP-1 RAs (11.6%); and T2DM with OSA prescribed metformin and GLP-1 RAs (8.1%). The groups without GLP-1 RA prescriptions were compared to those with prescriptions.

The researchers found that following propensity score matching, GLP-1 RA-prescribed groups had lower one-year mortality, both those without and with OSA (relative risks, 2.04 and 2.45, respectively). Between non-OSA and OSA cohorts, the ratio of relative risks was 1.20, indicating a 20% greater mortality benefit in the OSA population, with a significant Cochran-Mantel-Haenszel statistic.

“This large-scale analysis suggests that OSA status may act as an effect modifier in the association between GLP-1 RA prescription and mortality,” Fowler said in a statement.

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