Analysis of NHANES: Nutrient, Food, and Beverage Intake of Glucagon-Like Peptide-1 Receptor Agonist Users with Type 2 Diabetes, 2007-2020.

BACKGROUND

There is increasing use of glucagon-like peptide-1 receptor agonists (GLP1-RAs) for the treatment of obesity and diabetes.

OBJECTIVES

This study aims to evaluate differences in dietary intake among GLP1-RA users compared with nonusers and determine if length of use was associated with dietary intake in the United States.

METHODS

National Health and Nutrition Examination Survey data (2007-2020) were used to identify individuals with diabetes aged ≥30 y with complete demographics, anthropometric, dietary intake, and prescription medication use details, and not currently breastfeeding or pregnant. Nutrient intake and adequacy, and intake of United States Department of Agriculture-defined food categories were compared across 3 groups consisting of non-GLP1-RA users (n = 4247), short-term users (GLP1-RA use <1 y; n = 42), and long-term users (GLP1-RA use ≥1 y; n = 85). The likelihood of meeting the dietary reference intake and dietary intake was assessed with multivariable regression models.

RESULTS

Compared with nonusers, nonsignificantly lower mean energy intakes were observed among short-term users (1900 vs. 1700 kcal, respectively), and nonsignificantly higher average energy intakes were noted among long-term users (1900 vs. 2100 kcal). Compared with nonusers, short-term users displayed nutritional inadequacies for folate (69% vs. 49%, P = 0.042), iron (63% vs. 27%, P = 0.001), niacin (57% vs. 26%, P < 0.001), potassium (95% vs. 71%, P = 0.001), and vitamin B-6 (66% vs. 47%, P = 0.011). Food consumption varied with increased intake of higher-carbohydrate food categories (e.g., rice) in the nonusers and higher-protein food categories (e.g., beef) among users. Long-term users appear to have food consumption patterns that more closely resemble those of nonusers than those of short-term users. Similar results were noted for analyses restricted to obese individuals.

CONCLUSIONS

Observed findings suggest a lower likelihood of being nutritionally inadequate among short-term GLP1-RA users. Additional investigations are warranted to understand the dynamic nutritional needs of individuals using GLP1-RAs based on the duration of treatment.