Popular medications based on GLP-1 may help prevent prediabetes from progressing to type 2 diabetes among adults with obesity, according to findings from a large observational study. The drugs were also associated with a substantially lower risk of death compared with metformin.

Adults taking the medications had a 31% lower risk of developing type 2 diabetes and a 41% lower risk of death from any cause. Researchers reached those findings after comparing outcomes over a three year follow up period.

The study examined electronic health records from 256,492 adults with prediabetes and obesity. Participants had an average age of 52, and approximately half received medications based on GLP-1 while the other half received metformin.

The GLP-1 group included patients taking semaglutide, tirzepatide, liraglutide and dulaglutide. These medicines are glucagon like peptide 1 receptor agonists and can produce greater weight loss than metformin, according to the study author.

The research is scheduled for presentation at the American Heart Association’s Scientific Sessions 2026 this weekend in Chicago. The findings remain preliminary because they have not completed the full peer review process or been published in a peer reviewed journal.

Beyond the reduced risks of diabetes and death, medications based on GLP-1 were associated with 20% fewer strokes and 15% fewer heart attacks. Researchers also found an association with 25% fewer cases of heart failure.

“The 41% lower risk of death from any cause surprised me most,” study author Vinicius de Sousa Barzon Serra, M.D., a research fellow in the department of cardiovascular medicine at the Mayo Clinic in Scottsdale, Arizona, told Fox News Digital.

Serra said he expected the medications to outperform metformin in measures involving blood sugar and diabetes risk because they lead to considerably more weight loss. He was also struck by the apparent benefits across outcomes including heart attack, stroke, heart failure and atrial fibrillation.

Nearly 40% of adults in the United States have prediabetes, according to American Heart Association statistics cited in the report. Prediabetes is marked by blood sugar that is above normal but not high enough to meet the threshold for a diabetes diagnosis.

As many as 10% of people with prediabetes develop type 2 diabetes each year. Serra said most earlier research involving these medications had concentrated on people who already had diabetes rather than those at the prediabetes stage.

“Our study suggests the prediabetes stage may be an important time to consider them, rather than waiting until they develop type 2 diabetes,” Serra said. However, the observational study found an association and did not establish that the medications caused the improved outcomes.

Dr. Bradley Serwer, an interventional cardiologist and chief medical officer at VitalSolution, said the study raises the possibility that GLP-1 medications could have a substantial role in primary cardiovascular prevention. Serwer was not involved in the research.

“We have long known the benefits of controlling blood pressure, cholesterol and urging smoking cessation, but now we should consider aggressively treating obesity and metabolic dysfunction,” Serwer told Fox News Digital.

Researchers attempted to make the groups comparable by matching patients according to age, health conditions and other characteristics. Even so, Serra acknowledged that other differences between the groups may have remained, and the researchers could not determine whether individual GLP-1 drugs produced different outcomes.

The electronic health records used in the study may also have included missing or inaccurate information. Medication dosage, whether patients followed their treatment plans and other factors not measured by researchers could have affected the results.

Metformin remains a safe and inexpensive option with a lengthy record of use, Serra said. The oral medication is primarily used to treat type 2 diabetes, but it is also prescribed to some people with prediabetes to help prevent or delay progression.

Serra emphasized that healthy eating, regular physical activity and weight management remain the foundation of treatment. He advised people with prediabetes and obesity to discuss their options with a doctor and not stop or alter medication without medical guidance.

“For some patients, a GLP-1 medication may be worth discussing, depending on their overall health, other medical conditions, cost and access,” Serra said. “The decision should be made together with their doctor.”

Serwer similarly cautioned that not everyone with prediabetes needs a GLP-1 medication. He said clinicians need to identify patients with obesity, insulin resistance and multiple cardiovascular risk factors who are most likely to benefit from early intervention.