Dulaglutide significantly cut stroke risk by 23%, while semaglutide reduced cardiovascular mortality 26% in T2DM patients.

Patients with type 2 diabetes mellitus (T2DM) face a substantially elevated risk of cerebrovascular events, including stroke, which significantly contributes to morbidity and mortality. Current standard-of-care for T2DM primarily focuses on glycemic control, but often falls short in comprehensively addressing the multifactorial cardiovascular risks associated with the disease. Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) are increasingly recognized for their pleiotropic effects beyond glucose regulation, including potential benefits on cardiovascular and cerebrovascular health. This study specifically investigates and compares the efficacy and safety of various GLP-1 RAs in mitigating stroke risk and other cerebrovascular outcomes, aiming to identify optimal therapeutic strategies within this drug class.

Researchers conducted a frequentist network meta-analysis, systematically searching PubMed, Scopus, Web of Science, and Cochrane CENTRAL databases up to November 12, 2025. The analysis included randomized controlled trials (RCTs) that assessed the efficacy and safety of GLP-1 RAs compared to placebo in patients diagnosed with type 2 diabetes mellitus (T2DM). Data from ten studies encompassing 67,769 patients were pooled using R software to calculate risk ratios (RRs) with corresponding 95% confidence intervals (CIs). The study evaluated seven specific GLP-1 RAs: dulaglutide, efpeglenatide, exenatide, semaglutide, liraglutide, albiglutide, and lixisenatide.