Glucagon-Like Peptide-1 Use and Healthcare Resource Utilization for Depression and Anxiety Among Adults with Type 2 Diabetes: 2019 to 2023.

Mental health disorders, including depression and anxiety, are common comorbidities in individuals with type 2 diabetes mellitus (T2DM), contributing to increased healthcare resource utilization (HCRU) and the financial burden of the disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are commonly used for T2DM management, and emerging evidence suggests they may help alleviate mental health symptoms. This study examined the association between GLP-1RA (versus DPP-4 inhibitor [DPP-4i]) initiation and mental health-related HCRU in T2DM patients. Using data from the Komodo Healthcare Map, a national database of pharmacy and medical claims, this study conducted a retrospective cohort analysis with 774,968 adults who initiated GLP-1RAs or DPP-4i between January 2019 and March 2022. Patients were followed for 12 months, and mental health-related HCRU (emergency department, inpatient, outpatient hospital, and office visits) for depression and anxiety was assessed. A difference-in-differences analysis compared HCRU before and after medication initiation, adjusting for sociodemographic and clinical variables. GLP-1RA use was associated with significant reductions in outpatient hospital visits (IRR: 0.96; 95% CI: 0.95-0.98) for depression, and office visits for depression (IRR: 0.87; 95% CI: 0.82-0.92) and anxiety (IRR: 0.85; 95% CI: 0.81-0.90) compared to DPP-4i. However, no significant changes were observed in emergency or inpatient visits. Reductions were more pronounced with semaglutide, liraglutide, and dulaglutide. These findings suggest that GLP-1RAs may help reduce depression- and anxiety-related HCRU in patients with T2DM, indicating potential benefits beyond glycemic control. Further research is needed to explore long-term outcomes and the cost-effectiveness of GLP-1RAs for managing mental health comorbidities.