1 medications used to treat type 2 diabetes and obesity are associated with an increased risk of hair loss – especially non-scarring alopecia – in adults with type 2 diabetes, a new study has found
While the study’s authors noted the absolute risk of hair loss was low, they said ‘awareness of this potential effect may support informed, patient centred treatment decisions.’
The US-based researchers conducted the target trial emulation study using electronic patient data in response to reports that GLP-1 medication use, particularly semaglutide and tirzepatide, was associated with alopecia
The study, published in The BMJ, compared rates of alopecia in adults with type 2 diabetes who started using GLP-1 receptor agonists or two other types of diabetes drugs – SGLT-2 inhibitors and DPP-4 inhibitors – between January 2019 and September 2024
In total, 12,004 patients using GLP-1 receptor agonists were compared with 15,221 patients using SGLT-2 inhibitors and a further 11,964 GLP-1 users were compared with 11,233 DPP-4 inhibitor users
After adjusting for other factors, such as age and pre-existing conditions, GLP-1 use was associated with a 37% and 68% higher risk of developing alopecia than use of SGLT-2 inhibitors and DPP-4 inhibitors, respectively
Further analyses indicated that the association was specific to non-scarring alopecia – where hair follicles remain intact, leaving the potential for regrowth – with an increased risk of 53–72% compared with the other two diabetes medications
Dr Marie Spreckley, weight management researcher at the University of Cambridge, said: ‘The study found that GLP-1 receptor agonist use was associated with a higher relative risk of clinically recorded non-scarring hair loss than two alternative classes of diabetes medication.’
However, Dr Spreckley clarified: ‘It is important to interpret these findings alongside the absolute risk, which remained low at 6.91 cases per 1,000 person-years among GLP-1 receptor agonist users, compared with 5.04 and 3.89 cases per 1,000 person-years in the comparator groups.’
‘In practical terms, this means around two to three additional clinically recorded cases of hair loss per 1,000 person-years of treatment compared with the alternative diabetes medications.’
This study could not establish causality and only demonstrated a correlation between hair loss and GLP-1 weight-loss drugs
The authors point out that rapid <a href="https://healthylife7.com/watch-swamp247s-graham-hall-attempts-florida-te-heze-kents-weight-loss-workout/" title="Watch: Swamp247's Graham Hall attempts Florida TE Heze Kent's weight loss workout”>weight loss, which can be caused by GLP-1 use, is a well-established trigger of hair shedding and can also lead to iron or zinc deficiencies, which disrupt the hair growth cycle
Hormonal changes may also be relevant, they said, and further studies are needed to clarify the underlying mechanisms
More recently, a study in The BMJ found that adding the GLP-1 drug tirzepatide to standard care for patients with type 2 diabetes and heart disease is associated with a lower risk of a major cardiovascular event, such as a heart attack or stroke
These findings follow the National Institute for Health and Care Excellence’s (NICE’s) decision in April to make the weight-loss jab semaglutide available to NHS patients in England and Wales to help reduce the risk of major cardiovascular events
The same decision followed for NHS patients in Scotland in June, following recommendations from the Scottish Medicines Consortium
A total of 52,971 people were included in BMJ’s analysis, of whom 35,353 started tirzepatide and 17,618 started the comparator drug, a DPP-4 inhibitor called sitagliptin
According to the authors, the main outcome of interest was the reduction in major cardiovascular events, with tirzepatide associated with a 33% lower risk of heart attack compared with sitagliptin
Notably, however, ischaemic stroke showed no meaningful difference between the two medications
The study also found that fewer people in the tirzepatide group needed to be hospitalised for infections, and fewer also died from infections or from any cause
While this is an observational study, the authors said it adds to ‘the growing and consistent evidence base’ supporting the cardiovascular benefits of GLP-1 receptor agonists
Nevertheless, more studies – with longer follow-up, and randomised and pragmatic comparisons – are needed, the authors said
They conclude: ‘The signal is compelling; the causal and clinical placement questions remain open.’
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