This multicenter retrospective cohort study used TriNetX EHR data (Dec 2017–Apr 2026) to evaluate whether GLP-1 receptor agonist (GLP-1 RA) use in adults with type 2 diabetes (T2D) is associated with incident smell and taste disturbances, compared to other antidiabetic medications, with up to 2 years of follow-up after propensity score matching.
After matching 438,474 patients per cohort, GLP-1 RA users had a 48% higher risk of combined smell/taste disturbances (HR 1.48; 95% CI 1.37–1.61), a 81% higher risk of smell disturbances alone (HR 1.81; 95% CI 1.58–2.07), and a 52% higher risk of taste disturbances alone (HR 1.52; 95% CI 1.35–1.71) versus matched controls.
- ICD code–based outcome ascertainment likely undercounts true incidence (coding bias, underreporting). - Retrospective observational design cannot establish causality, and residual confounding from unmeasured variables is possible. - Specific GLP-1 RA agents were not individually analyzed, so drug-level effects remain unclear.
Clinicians prescribing GLP-1 RAs should proactively ask patients about changes in smell or taste, as this study signals a meaningful increased risk of these disturbances. Reporting suspected cases to pharmacovigilance systems may help clarify the true incidence and mechanism.
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