GLP-1 drugs and healthy lifestyle habits linked to lower cardiovascular risk in type 2 diabetes

A cohort study of more than 98,000 adults with type 2 diabetes found that use of GLP-1 receptor agonists combined with adherence to multiple healthy lifestyle habits was associated with reduced risk of major adverse cardiovascular events. The study, led by Harvard T.H. Chan School of Public Health and published Feb. 25, 2026 in The Lancet Diabetes & Endocrinology, also reported independent benefits from healthy habits and from GLP-1 RA use alone.

Researchers analyzed data from over 98,000 adults with type 2 diabetes and no prior cardiovascular disease from the Veterans Affairs Million Veteran Program covering 2011–2023. The study, led by Harvard T.H. Chan School of Public Health and collaborators at the VA Boston Healthcare System, is described as the first large cohort study to examine combined effects of GLP-1 receptor agonists and lifestyle habits on cardiovascular outcomes. Investigators assessed eight healthy habits (healthy diet, regular exercise, not smoking, restful sleep, low alcohol intake, stress management, social connection/support, and no opioid use disorder) and tracked major adverse cardiovascular events (non-fatal stroke, myocardial infarction, or cardiovascular death). The paper was published Feb. 25, 2026 in The Lancet Diabetes & Endocrinology. Key findings: - Sample: more than 98,000 people with type 2 diabetes; over 13,000 used a GLP-1 receptor agonist. - Combined effect: GLP-1 RA users who adhered to six to eight healthy habits had a 43% lower risk of major adverse cardiovascular events compared with non-users who followed three or fewer habits. - Independent effects: adherence to all eight healthy habits was associated with a 60% lower risk compared with one or fewer habits; GLP-1 RA use alone was associated with a 16% lower risk compared with non-use. - Analysis accounted for demographic and health-related confounders, but residual confounding from socioeconomic and other factors is acknowledged. - Population notes: the cohort was primarily white male veterans, which the authors say may limit generalizability though findings were broadly consistent across groups. Summary: The study reports that lifestyle habits and GLP-1 receptor agonist use were each associated with lower rates of major cardiovascular events, and that combined use and habit adherence showed larger associations than either approach alone. Undetermined at this time.