{"title":"2型糖尿病患者饮食行为模式与GLP-1受体激动剂治疗效果之间的关系：一项多中心前瞻性观察研究","authors":"Yuya Koide, Takehiro Kato, Makoto Hayashi, Hisashi Daido, Takako Maruyama, Takuma Ishihara, Kayoko Nishimura, Shin Tsunekawa, Daisuke Yabe","doi":"10.3389/fcdhc.2025.1638681","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used to improve glycemic control and induce weight loss in individuals with type 2 diabetes (T2D), yet treatment responses vary significantly among individuals. Eating behavior has been hypothesized to influence therapeutic efficacy, but supporting evidence remains limited.</p><p><strong>Methods: </strong>In this multicenter, prospective observational study, we enrolled 92 individuals with T2D initiating GLP-1RA therapy (liraglutide, dulaglutide, oral semaglutide, or injectable semaglutide) at four institutions in Gifu Prefecture, Japan. Participants were assessed at baseline, 3 months, and 12 months for clinical parameters, dietary intake, and eating behaviors using validated tools (Food Frequency Questionnaire and the Japanese version of the Dutch Eating Behavior Questionnaire [DEBQ-J]). Primary and secondary outcomes included changes in HbA1c, body weight, and eating behavior patterns over 12 months.</p><p><strong>Results: </strong>GLP-1RA therapy significantly reduced HbA1c, body weight, and body fat percentage at 12 months. Notably, external eating scores showed a sustained decrease, while emotional and restrained eating scores exhibited transient changes. Higher baseline external eating scores were independently associated with greater weight reduction and showed a trend toward enhanced glycemic improvement. No significant associations were observed between emotional or restrained eating scores and clinical outcomes.</p><p><strong>Conclusion: </strong>This study demonstrates that GLP-1RAs improve both metabolic parameters and external eating behavior in T2D individuals. External eating emerged as a potential behavioral marker predictive of treatment response. These findings suggest that integrating eating behavior assessments may help personalize GLP-1RA therapy and optimize outcomes in clinical practice.</p><p><strong>Clinical trial registration: </strong>UMIN Clinical Trials identifier, UMIN000045362.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"6 ","pages":"1638681"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483915/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between eating behavior patterns and the therapeutic efficacy of GLP-1 receptor agonists in individuals with type 2 diabetes: a multicenter prospective observational study.\",\"authors\":\"Yuya Koide, Takehiro Kato, Makoto Hayashi, Hisashi Daido, Takako Maruyama, Takuma Ishihara, Kayoko Nishimura, Shin Tsunekawa, Daisuke Yabe\",\"doi\":\"10.3389/fcdhc.2025.1638681\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used to improve glycemic control and induce weight loss in individuals with type 2 diabetes (T2D), yet treatment responses vary significantly among individuals. Eating behavior has been hypothesized to influence therapeutic efficacy, but supporting evidence remains limited.</p><p><strong>Methods: </strong>In this multicenter, prospective observational study, we enrolled 92 individuals with T2D initiating GLP-1RA therapy (liraglutide, dulaglutide, oral semaglutide, or injectable semaglutide) at four institutions in Gifu Prefecture, Japan. Participants were assessed at baseline, 3 months, and 12 months for clinical parameters, dietary intake, and eating behaviors using validated tools (Food Frequency Questionnaire and the Japanese version of the Dutch Eating Behavior Questionnaire [DEBQ-J]). Primary and secondary outcomes included changes in HbA1c, body weight, and eating behavior patterns over 12 months.</p><p><strong>Results: </strong>GLP-1RA therapy significantly reduced HbA1c, body weight, and body fat percentage at 12 months. Notably, external eating scores showed a sustained decrease, while emotional and restrained eating scores exhibited transient changes. Higher baseline external eating scores were independently associated with greater weight reduction and showed a trend toward enhanced glycemic improvement. No significant associations were observed between emotional or restrained eating scores and clinical outcomes.</p><p><strong>Conclusion: </strong>This study demonstrates that GLP-1RAs improve both metabolic parameters and external eating behavior in T2D individuals. External eating emerged as a potential behavioral marker predictive of treatment response. These findings suggest that integrating eating behavior assessments may help personalize GLP-1RA therapy and optimize outcomes in clinical practice.</p><p><strong>Clinical trial registration: </strong>UMIN Clinical Trials identifier, UMIN000045362.</p>\",\"PeriodicalId\":73075,\"journal\":{\"name\":\"Frontiers in clinical diabetes and healthcare\",\"volume\":\"6 \",\"pages\":\"1638681\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483915/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in clinical diabetes and healthcare\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fcdhc.2025.1638681\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in clinical diabetes and healthcare","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fcdhc.2025.1638681","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Association between eating behavior patterns and the therapeutic efficacy of GLP-1 receptor agonists in individuals with type 2 diabetes: a multicenter prospective observational study.
Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used to improve glycemic control and induce weight loss in individuals with type 2 diabetes (T2D), yet treatment responses vary significantly among individuals. Eating behavior has been hypothesized to influence therapeutic efficacy, but supporting evidence remains limited.
Methods: In this multicenter, prospective observational study, we enrolled 92 individuals with T2D initiating GLP-1RA therapy (liraglutide, dulaglutide, oral semaglutide, or injectable semaglutide) at four institutions in Gifu Prefecture, Japan. Participants were assessed at baseline, 3 months, and 12 months for clinical parameters, dietary intake, and eating behaviors using validated tools (Food Frequency Questionnaire and the Japanese version of the Dutch Eating Behavior Questionnaire [DEBQ-J]). Primary and secondary outcomes included changes in HbA1c, body weight, and eating behavior patterns over 12 months.
Results: GLP-1RA therapy significantly reduced HbA1c, body weight, and body fat percentage at 12 months. Notably, external eating scores showed a sustained decrease, while emotional and restrained eating scores exhibited transient changes. Higher baseline external eating scores were independently associated with greater weight reduction and showed a trend toward enhanced glycemic improvement. No significant associations were observed between emotional or restrained eating scores and clinical outcomes.
Conclusion: This study demonstrates that GLP-1RAs improve both metabolic parameters and external eating behavior in T2D individuals. External eating emerged as a potential behavioral marker predictive of treatment response. These findings suggest that integrating eating behavior assessments may help personalize GLP-1RA therapy and optimize outcomes in clinical practice.
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