Abstract
We evaluated time-course changes and the relationship between eating behavior and glycemic profile during the treatment of 34 obese type 2 diabetic patients with the glucagon-like peptide-1 receptor agonist (GLP1-RA) semaglutide. Changes in dietary habits were evaluated using the Japan Society for the Study of Obesity questionnaire. Semaglutide improved body weight and hemoglobin A1C (HbA1c) 3 and 6 months after treatment. In addition, semaglutide led to marked improvements in the total scores for eating behavior items on the questionnaire. In particular, changes in the scores regarding the sensation of hunger, food preference, eating style, regularity of eating habits and emotional eating behavior were significantly improved during semaglutide treatment. By contrast, there were no significant changes in the scores for the recognition of weight and constitution and external eating behavior. Furthermore, changes in the scores regarding the sensation of hunger and food preference were correlated with changes in HbA1c after semaglutide treatment. Multivariable regression analyses showed that the change in the sensation of hunger was related to HbA1c during treatment. In conclusion, the GLP1-RA semaglutide regulates eating behavior, and, in particular, the sensation of hunger is closely related to the improvement in HbA1c by semaglutide in obese patients with type 2 diabetes.
Highlights
Obesity and type 2 diabetes mellitus (T2DM) are correlated with several lifestyle factors, including food intake [1,2,3]
In the Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN)-1 trial, semaglutide monotherapy significantly reduced glucose metabolism and body weight (BW) compared to placebo controls [16]
In agreement with previous studies, this study demonstrated that semaglutide treatment significantly affected both BW and glycemic control in obese patients with T2DM
Summary
Obesity and type 2 diabetes mellitus (T2DM) are correlated with several lifestyle factors, including food intake [1,2,3]. Many eating behaviors, such as feeding style, the sensation of hunger, food preference and the regularity of eating habits are associated with the development of T2DM and obesity [4,5]. Because GLP-1 secretion from the gut seems to be impaired in obese patients, GLP-1 secretion may play a role in the pathophysiology of obesity [13] Along these lines, increased secretion of GLP-1, induced by delivering nutrients to lower parts of the small intestines, may be one factor that explains weight loss and improvements in glycemic control. GLP-1 receptor agonists, such as liraglutide, reduce cardiovascular events in high-risk patients with type 2 diabetes [9,13]
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