ArticleDiabetologia2025
Early worsening of diabetic retinopathy in individuals with type 2 diabetes treated with tirzepatide: a real-world cohort study.
Article in Diabetologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessing the risk of diabetic retinopathy progression with GLP-1 receptor agonists: a systematic review and meta-analysis.BMC ophthalmology · 2026Pooled it
- Real-World Effectiveness and Safety of Tirzepatide in Type 1 Diabetes and Obesity: Impact on Glycaemia, Weight, and Cardiometabolic Risk Markers.Diabetes, obesity & metabolism · 2026Article
- Anti-obesity medications impacting the eye: An emerging concern - a narrative review.World journal of methodology · 2026Review
- Evaluating the therapeutic impact of tirzepatide in people with partial lipodystrophy.The Journal of clinical endocrinology and metabolism · 2026Observational
- Therapeutic potential of GLP-1 receptor agonists and SGLT2 inhibitors in diabetic neuropathy: a critical appraisal.Diabetology & metabolic syndrome · 2026Review
- Ocular complications from glucagon-like peptide-1 receptor agonists: Clinical evidence, potential mechanisms, and clinical recommendations.Journal of the Chinese Medical Association : JCMA · 2026Review
- Beyond Glycemic Control: Ocular Effects of Glucagon-like Peptide-1 Receptor Agonists.Vision (Basel, Switzerland) · 2026Review
- The Effects of GLP-1 Receptor Agonists on Retinal Microvascular Alterations.Biomedicines · 2026Review
- Article
- Retinal Outcomes in Diabetes: Antihyperglycemic Therapy, EWDR, and Perioperative Considerations.Biomedicines · 2026Review
- Angiogenesis and inflammation in the retinopathy risk of insulin and semaglutide - a review.International journal of retina and vitreous · 2026Review
- The Benefits and Risks of Glucagon-Like Peptide-1 Receptor Agonists on Ocular Diseases: A Narrative Review.Cureus · 2026Review
- A narrative review on tirzepatide's therapeutic potential in glycemic control and cardioprotection.Annals of medicine and surgery (2012) · 2026Review
- Reassessing retinopathy risk with tirzepatide therapy.Diabetologia · 2025Article
- No evidence that tirzepatide can worsen diabetic retinopathy.Diabetologia · 2025Article
- Article
- Tirzepatide-Induced Weight Loss and Normalization of Glycemia With Nerve Regeneration in Type 2 Diabetes: A Case Report.Clinical diabetes : a publication of the American Diabetes Association · 2025Article
- The novel antidiabetic medications on diabetic retinopathy: relevant molecular mechanisms, advancing diagnostic innovations, and therapeutic implications.Frontiers in medicine · 2025Review
- Vitreous hemorrhage in a patient on tirzepatide: Coincidence or drug induced?Oman journal of ophthalmologyArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisEarly worsening of diabetic retinopathy (EWDR) has been described during treatment with glucagon-like peptide-1 receptor agonists including subcutaneous semaglutide. Whether EWDR occurs after initiating treatment with the potent glucagon-like peptide 1 / gastric inhibitory polypeptide receptor agonist tirzepatide is unknown.
methodsIn this retrospective cohort study using real-world clinical data, we matched 3435 tirzepatide-exposed (≥180 days treatment) individuals with type 2 diabetes 1:1 with 3434 tirzepatide-unexposed individuals for sex, diabetes duration, retinopathy status, HbA
resultsIndividuals included in the study had tight baseline glycaemic control (mean HbA CONCLUSIONS/
interpretationTirzepatide therapy resulted in significantly increased odds of incident PDR, particularly in individuals with mild NPDR with maculopathy (grade R1M1), or moderate-to-severe NPDR with or without maculopathy (grade R2M0, R2M1). The increase in odds of progression would justify specialist ophthalmologist referral by Early Treatment Diabetic Retinopathy Study (ETDRS) criteria.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.