S1810 Impact of GLP-1 Receptor Agonists on IBD Outcomes in Patients With Diabetes Mellitus: A Meta-Analysis

Introduction: GLP-1 receptor agonists (GLP-1 RAs) are known for their metabolic benefits in managing diabetes mellitus (DM) and are thought to have anti-inflammatory effects. However, their impact on inflammatory bowel disease (IBD) outcomes among patients with both DM and IBD is not well understood. We conducted a systematic review and meta-analysis to evaluate IBD-related outcomes in patients with coexisting DM and IBD who were treated with GLP-1 RAs compared to those who were not. Methods: We conducted a systematic search of PubMed, Embase, Scopus, and Google Scholar through April 2025 to identify studies reporting IBD-specific outcomes in patients with coexisting DM, stratified by GLP-1 RA use. Outcomes of interest included hospitalization related to IBD, initiation of oral corticosteroid therapy, and IBD-related surgery. A meta-analysis was conducted using a random-effects model, and heterogeneity among studies was assessed using the I² statistic. Results: A total of 4 studies comprising 11,234 patients were included, with 3,905 patients in the GLP-1 RA group and 7,329 in the non-GLP-1 RA group. Patient ages ranged from 36 to 59 years. Among studies reporting sex distribution, 59.1% of participants were women. Among those reporting IBD subtype, 48.5% had ulcerative colitis (UC) and 51.5% had Crohn’s disease (CD). GLP-1 RA use was associated with a significantly lower risk of IBD-related surgery (OR 0.62; 95% confidence interval [CI] 0.47–0.83; P = 0.001; I² = 0%), with this effect driven primarily by patients with CD (OR 0.60; 95% CI 0.43–0.84). For oral corticosteroid use, no significant difference was observed between GLP-1 RA users and non-users (OR 1.10; 95% CI 0.92–1.31; P = 0.30; I² = 53%). Results remained similar with subgroup analyses for both UC (OR 0.99; 95% CI 0.61–1.61; P = 0.96) and CD (OR 1.18; 95% CI 1.01–1.37; P = 0.04). Similarly, hospitalization rates did not differ significantly between groups (OR 0.79; 95% CI 0.56–1.11; P = 0.18; I² = 84%). Subgroup analysis revealed no significant differences for UC (OR 0.97; 95% CI 0.54–1.75; I² = 89%) or CD (OR 0.97; 95% CI 0.80–1.18; I² = 18%). Conclusion: Our findings suggest that in patients with IBD and DM, GLP-1 RA use is associated with a significant reduction in the need for CD-related surgery. However, no consistent benefits were observed in hospitalization rates or corticosteroid use. Further studies are needed to explore the direct immunomodulatory effects of GLP-1 RAs on intestinal inflammation.