S1911 Impact of GLP-1 Therapy on Disease Outcomes in Patients With Inflammatory Bowel Disease and Type 2 Diabetes: A Nationwide Analysis

Introduction: Inflammatory bowel disease (IBD) involves immune dysregulation and inflammation in genetically predisposed individuals. Comorbidities like type 2 diabetes complicate management and influence treatment outcomes. Glucagon-like peptide-1 receptor agonists (GLP-RA), used for diabetes, exhibit potential anti-inflammatory effects. This study examines associations between GLP-RA therapy and IBD outcomes (vs other anti-diabetic treatments) in patients with IBD and type 2 diabetes. Methods: The 2019-2020 National Inpatient Sample (NIS) was analyzed for patients with diabetes (types 1/2) and IBD (ulcerative colitis/Crohn’s), identified via International Classification of Diseases-10 codes. Groups included GLP-RA users and non-users. The primary outcomes assessed were corticosteroid use, IBD-related surgeries, and length of stay (LOS). Baseline characteristics were compared using descriptive analysis. Univariate and multivariate Cox regression analyses were performed to evaluate the association between GLP-1 agonist use and each primary outcome, adjusting for covariates. All statistical analyses were conducted using Python version 3.13.0. Results: A total of 829 patients with IBD and DM were included in the study. Of these, 69.7% had UC, and 55.7% were women. The mean age of the cohort was 61 ± 15.3 years. GLP-RA use was associated with a significantly reduced composite outcome, including shorter length of stay, fewer IBD-related surgeries and decreased need for corticosteroids (adjusted hazard ratio [aHR]: 0.55, 95% confidence interval [CI]: 0.34–0.89, P = 0.012). The protective effect of GLP-RAs was more pronounced in patients with obesity (aHR: 0.91, 95% CI: 0.91–0.92). Similar trends were observed for corticosteroid use, although patients with complicated diabetes had a significantly increased risk of corticosteroid use (aHR: 3.76, 95% CI: 3.63–3.89). Additionally, corticosteroid use was associated with an increased risk of IBD-related surgeries (aHR: 2.74, 95% CI: 1.53–4.88). Other individual outcomes did not reach statistical significance in multivariate analysis. Conclusion: Our study shows GLP-RAs improve outcomes in IBD patients with type 2 diabetes, particularly those with obesity. This may reflect the “obesity paradox,” driven by weight loss, enhanced metabolic regulation, and immune modulation via reduced pro-inflammatory cytokines. These results support GLP-RAs as a therapeutic strategy for IBD patients with metabolic comorbidities.