JMIR Publications

ABSTRACT

Background:

The clinical use of anti-diabetes drugs (ADDs) has expanded significantly in recent years, as glucagon-like peptide-1 (GLP-1) receptor agonists are now widely prescribed for weight loss. These shifts may be altering public perceptions and affecting diabetes treatment accessibility.

Objective:

To analyze the current online public discourse surrounding ADDs, with emphasis on perceptions of insulin versus non-insulin therapies and the increasing prominence of weight loss-associated medications.

Methods:

We conducted a retrospective analysis of 25,401 English-language tweets from the U.S. in 2023, using Boolean keyword searches to examine conversations about insulin-inclusive with/without weight loss terms, and insulin-exclusive with/without weight loss terms. We analyzed volume and sentiment of online conversations regarding ADDs; frequency of drug mentions; proportion of tweets by self-identified physicians; and thematic analysis of patient and clinician concerns.

Results:

26,832 tweets were collected in 2023. After tweet validation, 1,087 tweets mentioned insulin, and 22,493 tweets did not mention insulin.. Semaglutide-containing drugs such as Ozempic and Mounjaro were the most referenced medications, particularly in weight-loss contexts. Conversations about insulin-based therapies have declined compared to 2019. Only 7–10% of tweets 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 sentiment favored the dual efficacy of medications like Ozempic in managing diabetes and promoting weight loss.

Conclusions:

The discourse on ADDs has shifted towards weight-loss-oriented therapies, with GLP-1 agonists driving much of the engagement. This change reflects the evolution in public health interests and raises concerns regarding equitable access for diabetes patients. These findings underscore the need for updated clinical guidance, policy adaptations, and ongoing monitoring of public sentiment regarding chronic disease management medications.