Postpartum GLP-1 starts jump 24-fold

Clinical takeaway: Review breastfeeding status when discussing GLP-1 treatment after delivery, and counsel patients about the limited evidence on exposure during lactation. These prescribing data do not establish postpartum safety or effectiveness.

Pregnancy can reveal metabolic risk that persists after childbirth, particularly among women with gestational diabetes. Postpartum care offers an opportunity to reassess diabetes and weight-management needs as GLP-1 prescribing expands.

In a research letter published Oct 1, 2026, in JAMA, investigators analyzed commercial insurance claims for 1.04 million deliveries from January 2018 through March 2025, grouping patients by diagnoses recorded before delivery. Initiation meant a GLP-1 prescription fill within 6 months postpartum, with no fill during the 180 days before delivery.

Overall initiation increased from 0.08% in early 2018 to 1.9% in early 2025—approximately 24-fold. Women with type 2 diabetes consistently had the highest rates, increasing from 2.3% to 16.9%.

From mid-2021 to early 2025, initiation increased from 0.4% to 2.7% among women with gestational diabetes and from 0.4% to 3.9% among those with overweight or obesity. The overweight or obesity group accounted for 40% of initiators in the second half of 2024.

Most first fills occurred 3 to 6 months postpartum, but breastfeeding status was unavailable. Findings may not generalize beyond commercially insured patients, prescriptions obtained outside insurance were missed, and some apparent new starts may have been restarts after pregnancy.

“Postpartum is a critical window for addressing metabolic risk after pregnancy, and we’re seeing GLP-1 use explode in this population,” said lead author Sih-Ting Cai, PhD, of the USC Schaeffer Center. “Because evidence on GLP-1 exposure during breastfeeding remains limited, rising postpartum initiation warrants further study.”

Sources: Cai ST, et al. (2026 Oct 1) JAMA. Postpartum Initiation of GLP-1 Receptor Agonists Among Commercially Insured Women in the US; USC Schaeffer Center for Health Policy & Economics (2026 Oct 1). GLP-1 prescriptions for new mothers have increased sharply