Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Feb;61(2):265-272.
doi: 10.1007/s00125-017-4288-1. Epub 2017 May 14.

Medication use for the treatment of diabetes in obese individuals

John P H Wilding  1
Affiliations
Review

Medication use for the treatment of diabetes in obese individuals

John P H Wilding. Diabetologia. 2018 Feb.

Abstract

Obesity is a major cause of type 2 diabetes and may complicate type 1 diabetes. Weight loss for obese individuals with diabetes has many health benefits, often leads to improvement in glucose control and sometimes, in type 2 diabetes, near normalisation of abnormal glucose metabolism. Weight loss is difficult to maintain and attempts to lose weight may be undermined by some diabetes treatments such as sulfonylureas, thiazolidinediones and insulin. Whilst lifestyle support should be the primary approach to aid individuals who wish to lose weight, pharmacological approaches can also be considered. These include choosing glucose-lowering drugs or drug combinations that are weight neutral or result in weight loss or prescribing drugs that are specifically approved as anti-obesity medication. Given that some of the newer glucose-lowering medications that cause weight loss, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i), are also being used or considered for use as anti-obesity drugs, it seems that the distinction between glucose-lowering medication and weight loss medication is becoming blurred. This review discusses the main pharmacological approaches that can be used to support weight loss in individuals with diabetes.

Keywords: Diabetes; GLP-1 agonists; Lorcaserin; Naltrexone/bupropion; Obesity; Orlistat; Phentermine/topiramate; Review; SGLT2.

PubMed Disclaimer

Conflict of interest statement

Duality of interests

Consultancy (institutional) from AstraZeneca, Boehringer Ingelheim, Janssen, Lilly, Orexigen; grants to the institution from Takeda, Novo Nordisk and AstraZeneca; lecture fees (personal and institutional) from Astellas, AstraZeneca, Boehringer Ingelheim, Janssen, Lilly, Novo Nordisk, Orexigen, Sanofi.

Contribution statement

The author was the sole contributor to this review article.

References

    1. Skyler JS, Bakris GL, Bonifacio E, et al. Differentiation of diabetes by pathophysiology, natural history, and prognosis. Diabetes. 2017;66:241–255. doi: 10.2337/db16-0806. - DOI - PMC - PubMed
    1. Raum P, Lamparter J, Ponto KA, et al. Prevalence and cardiovascular associations of diabetic retinopathy and maculopathy: results from the Gutenberg Health Study. PLoS One. 2015;10:e0127188. doi: 10.1371/journal.pone.0127188. - DOI - PMC - PubMed
    1. Carnethon MR. Association of weight status with mortality in adults with incident diabetes. JAMA. 2012;308:2085–2085. doi: 10.1001/jama.2012.14669. - DOI - PMC - PubMed
    1. Henry RR, Brechtel G, Griver K. Secretion and hepatic extraction of insulin after weight-loss in obese noninsulin-dependent diabetes-mellitus. J Clin Endocrinol Metab. 1988;66:979–986. doi: 10.1210/jcem-66-5-979. - DOI - PubMed
    1. Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011;54:2506–2514. doi: 10.1007/s00125-011-2204-7. - DOI - PMC - PubMed