Effects of Oral Semaglutide on Dietary Intake and Body Composition in Japanese People With Type 2 Diabetes: A Prospective Observational Study in Clinical Practice

Abstract

Introduction

Glucagon-like peptide-1 receptor agonists are effective glucose-lowering agents with established benefits on body weight and cardiometabolic outcomes. However, their precise effects on body composition and dietary intake patterns, including food group consumption and macronutrient energy distribution, particularly in clinical settings, remain incompletely understood.

Methods

In this prospective observational study, we enrolled Japanese adults with Type 2 diabetes who were newly initiated on oral semaglutide treatment. Dietary intake patterns were assessed using a food frequency questionnaire, and body composition was assessed by bioelectrical impedance analysis. Handgrip strength and laboratory parameters were also evaluated. All parameters were assessed at both baseline (before the start of semaglutide treatment) and at a 3-month follow-up visit.

Results

A total of 25 participants were included in the final analysis. After 3 months of oral semaglutide treatment, significant reductions in HbA1c levels and body weight were noted. Significant reductions in the percent body fat and significant increases in the percent muscle mass were also observed. No significant change was observed in the handgrip strength. While the total energy intake decreased significantly after 3 months of semaglutide treatment, the macronutrient energy distribution remained unchanged. Analysis by food groups revealed significant reductions in the intakes of fats and oils, seasonings and spices, and sweets and snacks. Notably, the daily salt intake also decreased significantly from 8.9 to 7.0 g/day.

Conclusions

Oral semaglutide treatment was associated with reductions in the total energy intake and percent body fat, without significant changes in the macronutrient energy distribution or handgrip strength. Salt intake was also significantly reduced, suggesting potential clinical benefits of this treatment in the management of diabetes and related comorbidities.