The present review examined the effect of various anti-diabetes medications on weight, in order to determine the best pharmacological strategy for weight management in patients with type 2 diabetes mellitus (T2DM). Analysis included cumulative results from several representative studies that investigated weight changes in response to common T2DM drugs.
Weight gain, or obesity, is a root cause of Insulin Resistance, which, in turn, causes or aggravates diabetes. In addition, obesity contributes to some of the worse long-term complications of diabetes, such as heart attacks and stroke. Therefore, weight maintenance is an important element in the management of T2DM.
Most of the studies confirmed the weight benefits of Metformin (Glucophage), when used either alone or combined with other drugs. Metformin is one of the most used antidiabetic drugs for people with T2DM. It is usually the first drug used for control of blood sugar (for ‘glycemic control’).
New agents from the glucagon-like peptide-1 (GLP-1) agonists class, such as Exenatide (Byetta) and Liraglutide (Victoza), were also effective for weight maintenance. Patients on Exenatide registered greater weight reductions. Studies involving Liraglutide suggested a better glycemic control.
Drugs from the DPP-4 inhibitors class, such as Saxagliptin (Onglyza) and Sitagliptin (Januvia), and bile acid sequestrates (agents that reduce blood fats) have shown no effect on body weight.
Studies made on amilyn analogues, such as Pramlintide (Symlin), showed that it stimulates weight loss. It was also more effective for patients with high post-prandial blood sugar.
Insulin, the most effective agent for glycemic control, is typically associated with weight gain. Still, analysis showed that of all the types of insulin, Detemir (Levemir) demonstrated similar glycemic control as other insulin types, but caused less weight gain.
This analysis underlines the idea that reducing weight should be a priority in diabetes control. Even though lifestyle is an important aspect, as diabetes progresses medical treatment is needed. Of all investigated agents, Metformin had the highest weight-related benefit, followed by GLP-1 agonists and amylin analogues. On the other hand, DPP-4 inhibitors and bile-acid sequestrates had no effect upon weight.
Published By :
The Journal of Clinical Endocrinology & Metabolism
Date :
Nov 01, 2011
