# Adverse events administering glucagon-like peptide-1 receptor agonists: a cross-sectional study

## TL;DR

This study examines adverse events linked to GLP-1 drugs in the US, finding more administration issues compared to insulin, possibly due to increased use and supply shortages.

## Contribution

The study provides new insights into administration-related adverse events of GLP-1s compared to insulin, highlighting patterns tied to supply shortages.

## Key findings

- GLP-1s had a higher share of administration-related reactions (63%) compared to insulin (39%).
- Dosing issues and administration errors for GLP-1s increased starting in late 2022, coinciding with supply shortages.
- Increased reporting may reflect higher utilization rather than higher risk due to lack of exposure data in FAERS.

## Abstract

Rapid increased utilization of GLP-1s by US patients has raised safety concerns, in addition to challenges related to supply shortfalls starting in March 2022.

We analyzed publicly available FDA Adverse Event Reporting System (FAERS) data from January 2015 through December 2024 to describe adverse events where GLP-1s were the primary suspect and compared them with events involving injectable insulin products.

Among the 112 532 reports analyzed, GLP-1s were associated with a higher share of administration-related reactions (63%) compared to insulin (39%). Reports of dosing issues and administration errors increased for GLP-1s beginning in Q4 2022 and rose further in 2023 and 2024, patterns not seen for insulin. Increases coincided temporally with the period of national GLP-1 shortages. Increases in reporting volume may reflect increased utilization rather than increased risk as FAERS lacks exposure denominators.

The shift toward administration-related and dosing-related reports underscores the importance of patient and provider education and continued regulatory attention to the use of these drugs even as supply shortfalls resolve. Ongoing post-marketing surveillance remains essential to monitor safety signals.