Anti-diabetic drugs and weight loss in patients with type 2 diabetes

Abstract

Introduction: Obesity is frequently a comorbidity of type 2 diabetes. Even modest weight loss can significantly improve glucose homeostasis and lessen cardiometabolic risk factors in patients with type 2 diabetes, but lifestyle-based weight loss strategies are not long-term effective. There is an increasing need to consider pharmacological approaches to assist weight loss in the so called diabesity syndrome. Aim of this review is to analyze the weight-loss effect of non-insulin glucose lowering drugs in patients with type 2 diabetes.

Material and methods: A systematic analysis of the literature on the effect of non-insulin glucose lowering drugs on weight loss in patients with type 2 diabetes was performed. For each class of drugs, the following parameters were analyzed: kilograms lost on average, effect on body mass index and body composition.

Results: Our results suggested that anti-diabetic drugs can be stratified into 3 groups based on their efficacy in weight loss: metformin, acarbose, empagliflozin and exenatide resulted in a in a mild weight loss (less than 3.2% of initial weight); canagliflozin, ertugliflozin, dapagliflozin and dulaglutide induces a moderate weight loss (between 3.2% and 5%); liraglutide, semaglutide and tirzepatide resulted in a strong weight loss (greater than 5%).

Conclusions: This study shows that new anti-diabetic drugs, particularly GLP1-RA and Tirzepatide, are the most effective in inducing weight loss in patients with type 2 diabetes. Interestingly, exenatide appears to be the only GLP1-RA that induces a mild weight loss.

Keywords: Acarbose (PubChem CID: 41774); Anti-diabetic drugs; Body composition; Canagliflozin (PubChem CID: 24812758); Dapagliflozin (PubChem CID: 9887712); Diabesity; Empagliflozin (PubChem CID: 11949646); Ertugliflozin (PubChem CID: 44814423); Exenatide (PubChem CID: 45588096); Liraglutide (PubChem CID: 16134956); Metformin (PubChem CID: 4091); Semaglutide (PubChem CID: 56843331); Type 2 diabetes; Weight loss.