A review explores how newer diabetes drugs including GLP-1 receptor agonists and GLP-1/GIP dual agonists may influence anemia risk in type 2 diabetes patients, an overlooked complication that worsens cardiovascular health.
No specific guidelines existCurrent clinical guidelines lack recommendations for anemia prevention in T2DM patients using newer therapies like GLP-1 receptor agonists and GLP-1/GIP dual agonists
What the researchers found
The review identifies anemia as a prevalent but under-recognized complication in type 2 diabetes, particularly in patients with chronic kidney disease. It examines three classes of newer antidiabetic agents — SGLT2 inhibitors, GLP-1 receptor agonists, and combined GLP-1 RA/GIP agonists — for their potential effects on anemia risk.
The authors highlight that current clinical guidelines lack specific recommendations for anemia prevention and management in the context of these newer therapies, representing a significant gap in diabetes care. Early detection and management of anemia is emphasized as important for glycemic control, cardiovascular outcomes, and overall treatment success.
Why it matters
As GLP-1-based therapies become first-line treatments for millions of diabetes patients, understanding their effects on conditions like anemia is essential. Anemia worsens cardiovascular disease — already the leading cause of death in diabetes — so any drug that reduces anemia risk could provide significant additional benefit beyond blood sugar control.
How the study worked
This is a narrative review of existing literature examining the relationship between type 2 diabetes, anemia, and newer antidiabetic medications. The authors reviewed published research on SGLT2 inhibitors, GLP-1 receptor agonists, and GLP-1 RA/GIP dual agonists with respect to their effects on anemia risk and hematological parameters.
What this study cannot tell us
As a narrative review, this does not present original data or conduct a systematic search. The mechanisms by which GLP-1 RAs and GLP-1/GIP agonists might influence anemia are not yet well-established. The review acknowledges that further research is needed to understand these relationships, meaning current conclusions are largely hypothesis-generating rather than definitive.
How to read the evidence
This is a narrative review that synthesizes existing literature but does not present original data or follow systematic review methodology. It highlights a gap in knowledge rather than providing definitive evidence.
When this study was published
Published in 2025, this review addresses a timely gap in knowledge as GLP-1 and dual-agonist prescriptions continue to increase rapidly.
The bigger picture
The growing use of incretin-based therapies has revealed numerous effects beyond glucose control, including cardiovascular and kidney benefits. Understanding how these drugs affect anemia — a common comorbidity that impacts quality of life, exercise tolerance, and heart health — could influence treatment selection and monitoring strategies for the millions of people taking these medications.
Questions still open
- Do GLP-1 receptor agonists directly improve red blood cell production or iron metabolism in diabetes patients?
- Should hemoglobin and iron levels be routinely monitored in diabetes patients starting GLP-1-based therapies?
- Could the kidney-protective effects of GLP-1 drugs indirectly reduce anemia by preserving erythropoietin production?
Common questions
Can diabetes cause anemia?
Do GLP-1 drugs affect anemia risk?
Read the original research
Anemia risk and mitigation strategies in type 2 diabetic patients: The role of novel antidiabetic agents.
World journal of diabetes, 16(5), 105549
Citation
Meliš, Petra; Cigrovski Berkovic, Maja. (2025). Anemia risk and mitigation strategies in type 2 diabetic patients: The role of novel antidiabetic agents.. World journal of diabetes, 16(5), 105549. https://doi.org/10.4239/wjd.v16.i5.105549