A matched electronic health record study of more than 876,000 patients with type 2 diabetes found a low absolute incidence but higher relative hazard of documented smell and taste disturbances among patients prescribed glucagon-like peptide-1 receptor agonists.
To evaluate whether glucagon-like peptide-1 receptor agonist (GLP-1 RA) use is associated with incident smell and taste disturbances in patients with type 2 diabetes.
Approach:
Study Design: Retrospective cohort study analyzing electronic health records from the TriNetX Global Collaborative Network.
Participants: Included 438,474 patients prescribed GLP-1 RAs and 438,474 matched controls prescribed other antidiabetic medications.
Outcome Assessment: Outcomes assessed from 3 months to 2 years post-prescription, focusing on new-onset smell or taste disturbances identified through diagnostic codes.
Key Findings:
1,615 patients receiving GLP-1 RAs (0.37%) documented smell and taste disturbances compared to 960 controls (0.22%).
Absolute risk increase of 0.15%, equating to approximately 1.5 additional cases per 1,000 treated patients.
GLP-1 RA use associated with a 48% higher hazard of documented smell or taste disturbance.
Specific disturbances: anosmia (0.13% in GLP-1 RA vs 0.07% in controls), parosmia (0.05% vs 0.02%), and taste disturbances (0.18% vs 0.10%).
Interpretation:
Limitations:
Observational design does not establish causality.
Outcome identification relied on diagnostic coding rather than standardized testing.
Potential for misclassification due to reliance on patient-reported symptoms.
Residual confounding could not be excluded.
Data on adherence, treatment duration, and medication dose were unavailable.
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