Exploring Dietary Intake in Adults with Type 2 Diabetes Using GLP-1 Receptor Agonists: A Cross-Sectional Analysis.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in type 2 diabetes (T2D) management for their glycemic and weight benefits. However, their appetite-suppressing effects may influence dietary intake and nutrient adequacy, yet real-world evidence is scarce. To evaluate dietary intake and adherence to the Mediterranean diet in adults with T2D treated with GLP-1RAs compared to those receiving other oral hypoglycemic agents. In this cross-sectional study, 103 adults with T2D (mean age 66 ± 8 years; 65% male) attending a diabetes clinic in Turin, Italy, were enrolled between February and June 2025. Dietary habits were assessed using a validated food frequency questionnaire, and adherence to the Mediterranean diet was evaluated via the Mediterranean Diet Score (MDS). Anthropometric, biochemical, and lifestyle data were collected. Fifty-two participants (50.5%) were treated with GLP-1RAs (semaglutide 55.8%, dulaglutide 40.4%). No significant differences in energy intake, macronutrient distribution, or MDS were observed between groups. Overall, diets were characterized by low carbohydrate intake (~44% of energy), inadequate fiber (≈11 g/1000 kcal), and high fat intake (≈39-40% of energy), with saturated fat below 10%. None of the GLP-1RA users met fiber recommendations. Subgroup analysis by treatment duration (<1 year, 1-2 years, >2 years) revealed no significant differences in dietary patterns. Patients with T2D, regardless of pharmacological treatment, exhibited poor adherence to dietary guidelines. These findings highlight the need for structured nutritional counseling alongside GLP-1RA therapy to optimize metabolic outcomes and prevent nutritional deficiencies.