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

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.