COMPARISON OF GLP-1 AGONIST, LIFE STYLE AND DIET MODIFICATION VS GLP-1 AGONIST ALONE FOR TREATMENT OF DIABETIC PATIENTS WITH MASLD

Abstract

Objective: To assess the effectiveness of GLP-1 RAs therapy for patients with MASLD/T2DM and whether adding lifestyle and diet modifications to GLP-1 RA therapy provides additional benefit.

Study Design: Randomized Controlled trial.

Study setting and duration: Shaikh Zayed Hospital Lahore Department of Gastroenterology (December 2025- April 2026).

Methodology: A total of 72 patients with MASLD and T2DM participated in the study; they were randomized into two equal groups. Patients in Group A received GLP-1 RAs therapy alone, while patients in Group B received GLP-1 RAs therapy and lifestyle modification. The following measurements were assessed at baseline and follow-up: anthropometric measurements, fasting blood glucose, HbA1c, liver enzymes, and liver fat %age. Comparison of medians across groups for each measurement was done using the Mann-Whitney U test, with p≤0.05 being statistically significant.

Results: Participants treated with combination therapy showed a significantly larger decrease in BMI (3.15 (1.00) kg/m² v. 1.00 (0.40) kg/m²), waist circumference (11.00 (2.90) cm v. 3.90 (2.30) cm), fasting blood glucose (42.70 (12.10) mg/dL v. 15.35 (8.70) mg/dL), HbA1c (1.70 (0.40)% v. 0.70 (0.40)%), ALT (22.10 (6.60) U/L v. 7.90 (5.80) U/L), AST (19.95 (4.70) U/L v. 6.70 (6.40) U/L), and percentage of liver fat (4.75 (3.90)% v. 1.45 (3.30)%) than Group A participants (all p<0.001).

Conclusion: GLP-1 RAs therapy combined with lifestyle alterations and dietary modifications is more efficacious than GLP-1RAs monotherapy for improving anthropometric, glycemic, and hepatic outcomes among individuals with T2DM and MASLD.