After stopping Ozempic-like drugs, many diabetes patients actually return to treatment

GLP-1 drugs have reshaped the treatment landscape for type 2 diabetes and obesity in recent years, but after their real-world entry into everyday medical care, another question has gradually emerged: can patients use them long term? A retrospective study presented at the Endocrine Society’s annual meeting ENDO 2026 found that many patients with type 2 diabetes stop treatment midway, but stopping does not necessarily mean permanently leaving treatment. A substantial share restart medication within months to years.

The research team analyzed U.S. claims data from Komodo Health, including adults who started liraglutide, semaglutide, or tirzepatide between January 2019 and June 2025. Participants were 18 to 64 years old, all had type 2 diabetes, had a body mass index of at least 25, and had continuous insurance coverage before starting treatment. The study defined discontinuation as a gap of more than 60 days between prescription refills; obtaining another prescription after stopping was considered restarting treatment.

Among data from more than 60,000 patients, about 40% of users stopped GLP-1 drugs within the first year; by the second year of follow-up, the discontinuation rate approached 60%. The figure is a reminder that even when drugs show clear metabolic benefits in clinical trials, the real world is still shaped by side effects, accessibility, cost burden, and continuity of care.

More unexpectedly, stopping was not necessarily the endpoint. The researchers reported that 41.5% of patients restarted treatment within one year after discontinuation; by two years, the restart rate rose to 58%. In other words, in clinical practice GLP-1 therapy may look more like intermittent long-term management than a course of treatment that continues steadily after a single prescription.

The analysis also outlined groups more likely to stop treatment. Patients covered by Medicaid or Medicare, Black patients, and those who experienced gastrointestinal side effects such as nausea had a higher risk of discontinuation in the first year. By contrast, if the first GLP-1 prescription was written by an endocrinologist, the likelihood of discontinuation was lower; the study estimated the reduction at about 10%, suggesting that specialist follow-up, dose adjustment, and side-effect management may affect patients’ persistence.

There may also be differences between drug generations. According to the study, users of newer drugs such as tirzepatide had a lower risk of discontinuation than users of earlier drugs such as liraglutide; semaglutide users also had a lower risk of discontinuation. However, this result comes from insurance claims data and statistical models, and cannot directly prove that any one drug itself necessarily makes patients more willing to continue using it. Drug prices, coverage conditions, physician choice, and patient characteristics may all be involved.

Background Context

GLP-1 drugs are expanding from injectable diabetes medications into weight loss, heart and kidney protection, and competition among new oral drugs; but the intensity of drug development does not mean patients can smoothly maintain treatment in daily life. This study remains a conference presentation, and the publicly available abstract information is limited, so a full paper and more detailed data are still needed to confirm the reasons and differences. Still, it has already raised a practical signal: when evaluating GLP-1 efficacy, health systems cannot look only at whether the drugs work, but also at who can continue to obtain them, tolerate them, and be guided back onto an appropriate treatment path after an interruption.