NDSU and Sanford Health Are Studying What GLP-1 Drugs Actually Do in the Real World — and That's a Big Deal
A new academic-health system partnership aims to answer the GLP-1 questions that controlled clinical trials can't.
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NDSU and Sanford Health Are Studying What GLP-1 Drugs Actually Do in the Real World — and That's a Big Deal
Clinical trials are controlled. Real life is not.
That gap is exactly what North Dakota State University and Sanford Health are setting out to close. As reported by Valley News Live on June 25, 2026, the two institutions have jointly launched a study focused on the real-world effects of GLP-1 weight-loss drugs — the class that includes semaglutide and tirzepatide. The partnership brings together NDSU's pharmacy and health sciences expertise with Sanford Health's large regional patient network, a combination that could generate findings far more representative of everyday users than a tightly controlled pharmaceutical trial ever could.
Here's why this kind of research matters — and what it means for you.
Why "Real-World" Research Is Different From a Clinical Trial
When a drug gets FDA approval, the data behind it usually comes from randomized controlled trials. Those trials are gold-standard science, but they also involve carefully screened participants, strict protocols, and frequent monitoring that most people will never experience at their local clinic.
Real-world evidence studies, by contrast, track what happens to actual patients — people who miss doses, have other health conditions, take other medications, and don't always follow the rulebook. A 2025 review in Diabetes, Obesity and Metabolism specifically called for more real-world evidence on GLP-1-based therapies, noting gaps in understanding their comparative effectiveness and adverse effects across diverse populations. The NDSU–Sanford collaboration is a direct answer to that call.
The Questions That Still Need Answering
The GLP-1 space has no shortage of impressive trial data. But real-world researchers are zeroing in on a few stubborn unknowns.
What happens when people stop? A June 2026 study in EClinicalMedicine specifically examined weight maintenance after GLP-1 therapy is discontinued — a question that's become urgent as more people cycle on and off these drugs due to cost, side effects, or supply issues. A companion June 2026 paper in Diabetes, Obesity and Metabolism reviewed the cardiometabolic consequences of stopping GLP-1 receptor agonists, underscoring that discontinuation is not a neutral event.
What about cardiovascular outcomes in the real world? A March 2026 study called STEER, published in Diabetes, Obesity and Metabolism, looked at semaglutide and tirzepatide's cardiovascular effects in real-world patients with overweight or obesity — and a January 2026 Nature Medicine study examined cardiovascular outcomes for both drugs in type 2 diabetes patients in clinical practice. The field is moving fast, but regional data — like what NDSU and Sanford can collect from the Northern Plains — adds texture that national studies often miss.
Why a Midwest Academic-Health System Partnership Makes Sense
Sanford Health operates one of the largest rural health networks in the country, spanning the Dakotas and surrounding region. That patient base reflects a demographic — often older, often with multiple chronic conditions, often in areas with limited specialty care access — that is underrepresented in the clinical trials that got these drugs approved.
MedlinePlus notes that more than 70 percent of U.S. adults are overweight or have obesity, and that weight-related health conditions extend well beyond the scale to include type 2 diabetes, heart disease, and kidney disease. Understanding how GLP-1 drugs perform across that full, messy spectrum — not just in ideal trial conditions — is essential before these medications become a decades-long standard of care.
NDSU's pharmacy faculty bring the pharmacoepidemiological tools to analyze prescription patterns, adherence, and side-effect reporting at scale. Sanford brings the patient records. Together, that's a meaningful research engine.
Real-World Studies Are Also Catching Things Trials Miss
It's worth noting that real-world evidence has already added nuance to what we thought we knew. Trials like STEP and SURMOUNT showed dramatic weight loss. But real-world adherence data, side-effect patterns at scale, and outcomes in patients with complex comorbidities often look different once you zoom out.
A 2024 randomized trial in EClinicalMedicine that combined GLP-1 therapy with exercise found that weight loss maintenance one year after stopping treatment was significantly better in the combination group — a finding with real implications for how these drugs should be prescribed, not just whether they work.
That's the kind of practical, actionable signal that real-world research is built to generate.
What This Means for You
- The science on GLP-1 drugs is still being written. The NDSU–Sanford study is part of a broader push to understand what these medications do outside of controlled settings — which is the world you actually live in.
- What happens when you stop matters. Multiple 2026 studies are now focused on discontinuation effects. If you're on a GLP-1 drug and considering stopping, that's a conversation to have with your prescriber, not a solo decision.
- Regional and diverse data improves everyone's care. Studies based on Midwest rural health networks fill gaps that coastal academic medical centers can't. More representative data means better guidance for more people.
Not medical advice. Talk to your prescriber about your specific situation, medications, and health history.
