Social Media Discussions of Anti-Diabetic Drugs and the Popularity of GLP-1 Therapies: Content Analysis.

Background: The clinical use of antidiabetic drugs (ADDs) has gained prominent public visibility due to the Food and Drug Administration (FDA) expansion of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in recent years; these drugs are now widely prescribed for weight loss. This shift is reflected in online public discourse. Objective: This study aimed to analyze the current online public discourse surrounding ADDs, with an emphasis on perceptions of insulin versus noninsulin therapies and the increasing prominence of weight loss-associated medications. Methods: We conducted a retrospective analysis of 23,580 English-language posts from the United States in 2023, using Boolean keyword searches to examine conversations about insulin-inclusive, with or without weight loss terms, and insulin-exclusive, with or without weight loss terms. We analyzed the volume and sentiment of online conversations regarding ADDs, frequency of drug mentions, proportion of posts by self-identified physicians, and thematic analysis of patient and clinician concerns. Results: A total of 26,832 initial posts were collected in 2023. After post validation, 23,580 posts remained as the study sample size. Of the 23,580 posts, 4.6% (1087/23,580) mentioned insulin, and 95.4% (n=22,493) did not mention insulin. Semaglutide-containing drugs such as Ozempic and Mounjaro were the most referenced medications, particularly in weight-loss contexts. Weight loss conversations made up the majority of online posts. Conversations about insulin were marginal compared with conversations that did not mention insulin online. Only 7% to 10% of posts came from self-identified physicians. Key themes included drug accessibility, off-label use for weight management, concerns about supply shortages, insurance coverage, and growing calls for holistic care. Notably, public perspectives favored the dual efficacy of medications like Ozempic in managing diabetes and promoting weight loss. Conclusions: The discourse on ADDs is dominated by weight loss-oriented therapies, with GLP-1 RAs driving much of the engagement. This surveillance paper illustrates the current state of public health interests around antidiabetic medications associated with weight loss and raises concerns regarding equitable access for patients with diabetes. These findings underscore the need for updated clinical guidance on necessary lifestyle behaviors for antidiabetic medication use and ongoing monitoring of public opinions regarding chronic disease management medications.