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Type 2 diabetes drugs that induce weight loss

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Our easy-to-read fact sheets provide clinicians with reliable information to share with patients and their caregivers.

The main risk factor for type 2 diabetes is being overweight or obese, so weight loss goals while maintaining normal blood sugar levels are critical for some patients. In addition to lifestyle modifications, type 2 diabetes medications may help with weight loss.1,2

obesity

Obesity is defined as a body mass index (BMI) of 30 kg/m3.2 It is linked to many major health problems, including cardiovascular disease, osteoarthritis, and type 2 diabetes. Weight loss of 5% to 15% may improve obesity-related complications.1,2

Phentermine (Lomaira®), orlifast (Arai®), topiramate (Trokendi XR®), and naltrexone/bupropion (Contrave®). However, these are not indicated for the treatment of his type 2 diabetes.3

type 2 diabetes

Type 2 diabetes is a chronic disease due to progressive loss of insulin secretion and/or increased insulin resistance. As a result, the insulin your body naturally produces becomes less effective at reducing the amount of sugar in your blood. Excess body weight or excessive body fat percentage can cause some degree of insulin resistance. Most, but not all, people with type 2 diabetes are overweight or obese.

Different antidiabetic drugs work by different mechanisms to help lower blood sugar levels. Some of these drugs also provide additional benefits to patients, such as weight loss. Drugs that have weight loss effects include metformin, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists.2

Type 2 diabetes drugs that induce weight loss

Below is a list of FDA-approved medications for the management of type 2 diabetes that can result in weight loss. It is important to note that the amount of weight loss may vary depending on the drug, dose, duration of treatment, and lifestyle changes. Please contact your provider for additional information.

drug class How to use side effects
biguanide
metformin
Reduces glucose production by the liver and improves insulin sensitivityFour Nausea Vomiting Diarrhea Constipation Stomach pain Bloating Change in taste7, 8
SGLT2 inhibitor Canagliflozin (Invokana®) Dapagliflozin (Fasiga®) Empagliflozin (Jardiance®) Reduces reabsorption of filtered sugar and increases urinary glucose excretion.9 Increased urination Urinary tract infection (UTI) Female reproductive tract infection13
GLP-1 receptor agonist Dulaglutide (Trulicity®) exenatide
(Byetta®; Bydureon BCise®) liraglutide (Victoza®) Semaglutide (Libersus®; Ozempic®) Tirzepatide (Munjaro®)
Simulates GLP-1 receptors to increase insulin secretion and decrease glucagon secretion14 Nausea Vomiting Diarrhea Acute kidney injury Injection site reactionstwenty four

Differences in weight loss

biguanides

In long-term studies, patients who took metformin maintained an average weight loss of 6.2% during 6 to 15 years of treatment. Patients who experienced greater weight loss over time were those who (1) lost more weight during their first year of treatment and (2) were older.5,6

SGLT2 inhibitor

Various studies have demonstrated long-term weight loss effects in patients taking SGLT2 inhibitors. An analysis of multiple studies showed that after four years of treatment, patients lost an average of 1.5 kg to 2 kg. These effects increased as the dose of these drugs increased. Other studies have revealed that the average weight loss rate is 2.2% to 3.3% of the patient’s starting weight.5, 10-12

Other studies have shown improved weight loss in patients who combine SGLT2 inhibitors with other drugs such as metformin and GLP-1 receptor agonists. Therefore, SGLT2 inhibitors may also be the drug of choice for patients with heart and kidney disease.22,23 However, hypoglycemia is more likely to occur when used in addition than when used alone.30

GLP-1 receptor agonist

Studies have reported that the weight loss effects associated with GLP-1 receptor agonists range widely from 1 kg to 15 kg, depending on the drug.15-21 Weight loss effects vary depending on dose and treatment duration.Five

Similar to SLGT2 inhibitors, GLP-1 receptor agonists can be used as add-on therapy for patients with heart or kidney disease, but hypoglycemia is more likely to occur. 22, 23, 30

FAQ

Can I eat what I like while taking these medications?

No, food choices still play an important role in diabetes management.

Different types of diets for diabetics include Mediterranean diets, low-fat diets, low-carbohydrate diets, vegetarian diets, and vegan diets. Additionally, the Dietary Approaches to Stop Hypertension (DASH) approach may prevent more serious complications such as heart disease and kidney disease in people who have or are at risk for high blood pressure or high cholesterol. There is a gender.22,23

Dietary modifications can also increase natural GLP-1 and insulin production/sensitivity and prevent escalation of antidiabetic therapy while meeting nutritional needs.twenty four

Do I still need to exercise while taking these medications?

Yes, it is recommended to engage in regular physical activity, even if you are taking medications that can cause weight loss, to prevent the development or progression of heart- and kidney-related complications.

It is recommended that people with type 2 diabetes do 150 minutes of moderate-to-vigorous exercise per week or 75 minutes of vigorous-intensity exercise at least 3 days per week.twenty five Studies have reported that physical activity may contribute to increased efficacy of certain drugs, such as GLP-1 receptor agonists and metformin.25-27

How can I prevent side effects such as nausea, vomiting, diarrhea, bloating, and constipation?

Metformin can cause stomach upset during initial treatment and must be taken with food. These side effects should go away over time, so don’t skip doses or stop taking metformin without talking to your doctor.7,8

Initial doses of GLP-1 receptor agonists or SGLT2 inhibitors are usually low to prevent stomach problems, but not high enough to help manage blood sugar levels. Therefore, your healthcare provider may start you on a higher dose, but you should let your healthcare provider know if you can no longer manage the gastric side effects.28,29

Can I take more than one of these drugs at the same time?

Yes, according to guidelines from the American College of Clinical Endocrinologists and the American Diabetes Association, GLP-1 receptor agonists and/or SGLT2 inhibitors are recommended as add-on treatments to metformin, especially in patients at risk for heart or kidney disease. as preferred over other drug classes. .

Before adding these drugs, your doctor may consider factors such as heart or kidney disease, potential weight loss, and potential side effects.22,23 The concomitant use of GLP-1 receptor agonists and metformin may also worsen diarrhea.29

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