Nearly 17% of children in the study were diagnosed with a nutritional deficiency or related complication within a year of starting a GLP-1 medication.
Vitamin D deficiency was the most common issue, affecting 12.4% of patients within one year.
Nutrition counseling was relatively uncommon after children started GLP-1 treatment, with just 23.3% receiving it within six months.
GLP-1 medications have become an increasingly common treatment for children and teens with obesity, prediabetes or type 2 diabetes. These medications can help control blood sugar and reduce appetite, but that reduction in appetite also means some children may eat less overall.
For children and teenagers, getting enough nutrients is especially important because their bodies are still growing and developing. Researchers from Lurie Children's Hospital of Chicago wanted to take a closer look at whether nutritional deficiencies were being diagnosed among young people taking GLP-1 medications.
“As appropriate pediatric use of GLP-1s becomes more widespread, we need to understand the risks during periods of rapid growth and pubertal development,” senior author Justin Ryder, Ph.D., said in a news release. “Nutrients such as vitamin D, iron, and calcium are of particular concern during adolescence, when deficiencies may have lasting implications for skeletal health and overall development.
“Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated. In our study, however, we found that only 5% of patients received nutritional counseling within 30 days of GLP-1 treatment and less than 25% received nutritional counseling within six months.”
How the study worked
Researchers analyzed national health insurance claims data covering more than 100 million people between 2017 and 2022. They identified 2,031 children ages 10 to 17 who had recently started taking a GLP-1 medication and had no documented nutritional deficiency during the six months before treatment.
The researchers then looked at medical claims for up to one year after treatment began to identify diagnoses involving nutritional deficiencies or related complications. They also looked at whether patients received nutrition therapy or counseling and how soon that care occurred after starting medication.
Most of the children in the study had type 2 diabetes or obesity. Liraglutide was the most commonly prescribed GLP-1 medication, followed by dulaglutide and semaglutide.
Importantly, this was a retrospective study based on insurance claims. That means it can show patterns in diagnoses and care, but it cannot establish that GLP-1 medications directly caused the nutritional deficiencies.
What the researchers found
Within six months, 10.2% of the children had been diagnosed with at least one nutritional deficiency or related complication. By one year, that figure had risen to 16.8% — nearly one in six patients.
Vitamin D deficiency was by far the most common finding, diagnosed in 12.4% of children within a year. Nutritional anemia was diagnosed in 1.5%, while iron-deficiency anemia was diagnosed in 1.4%.
Nutrition counseling also wasn't common. Only 5.8% of children had received nutrition therapy within 30 days of starting a GLP-1, and 23.3% had received it within six months.
The researchers say the findings highlight the importance of monitoring nutrition when children begin GLP-1 treatment. The study doesn't show that every child taking these medications will develop a deficiency, but it does suggest that it may be important to add nutrition counseling into pediatric GLP-1 care.
“We hope that our study findings bring much needed recognition to the importance of proactive nutritional management when GLP-1s are prescribed to children, as opposed to waiting until a nutritional deficiency is diagnosed,” said Dr. Ryder. “Knowing the risks, we are in a much better position to prevent harm to children treated with GLP-1s during a pivotal period in their lives.”