Nutritional deficiencies and muscle loss in adults with type 2 diabetes using GLP-1 receptor agonists: A retrospective observational study

Document Type

Article

Publication Date

6-10-2025

Publication Title

Obesity Pillars

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) drug-induced weight loss is associated with fat mass reduction but can also lead to nutritional deficiencies and loss of muscle. We quantified nutritional deficiencies in adults who had undergone GLP-1RA treatment. Methods: This was an observational, retrospective analysis of de-identified patient-level claims data from 461,382 adults newly prescribed GLP-1RAs between 7/2017 and 12/2021 with no prior diagnoses of nutritional deficiencies. While most patients had type 2 diabetes (T2DM), the population also included individuals with type 1 diabetes (T1DM), prediabetes, or no recorded diabetes diagnosis. A secondary propensity-matched analysis compared GLP-1RA users with non-users. The matched comparator cohort consisted of adults with type 2 diabetes treated with metformin but not prescribed GLP-1RAs, whereas GLP-1RA users were treated with both metformin and GLP-1RA. Nutritional deficiencies were assessed at 6 and 12 months after GLP-1RA initiation. Nutritional deficiency diagnoses or complications were compared between patients with or without a dietitian visit within a 6-months of treatment initiation. Results: Patients were mainly female (56.3 %), mean age (±SD) 52.9 (±11.7) years, with obesity (44.9 %) or overweight (5.6 %); type 2 diabetes (80.5 %) and hypertension (66.3 %) were the most common comorbidities. Nutritional deficiencies were diagnosed in 12.7 % of the patients within 6 months after GLP-1RA initiation and in 22.4 % within 12 months. Vitamin D deficiency was most common, having an incidence of 7.5 % and 13.6 % within 6 and 12 months, respectively. Recorded nutrient deficiencies or deficiency-related complications were more likely among patients with a dietitian visit within the first 6 months of GLP-1RA initiation compared to patients without a dietitian visit. Conclusion: Over 20 % had nutritional deficiencies diagnosed within one-year of starting GLP-1RA treatment. These findings highlight the importance of nutritional screening and diagnosis of deficiencies and inclusion of physician nutrition specialists, dietitians, and other nutrition care specialists in patient care.

First Page

1*

Last Page

7

DOI

10.1016/j.obpill.2025.100186

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