The Buzz: Multiple classes of oral diabetes medications are weight-neutral or even beneficial for weight loss.
Citation: "Managing Type 2 Diabetes: Balancing HbA1c and Body Weight " Postgrad Med 2010 May 122(3):106-117.
Summary: Attempts at managing type 2 diabetes in the obese are often sabotaged by weight gain as a side effect of therapy. Weight loss has been shown to improve insulin resistance, improve glycemic control, and decrease the need for medication. Appropriate choice of medications in this population can help minimize weight gain and perhaps lead to weight loss, thus improving glycemic control and hopefully leading to improvements in overall cardiovascular risk. This review revealed that the antihyperglycemic agents most likely to be weight neutral or to promote loss were the biguanides (e.g. metformin), α-glucosidase inhibitors (e.g. acarbose), incretin mimetics (e.g. exenatide), amylin mimetics (e.g. pramlintide), DPP4-inhibitors (e.g. sitagliptin/saxagliptin). In addition, providers may consider the use of orlistat and sibutramine to target weight loss as adjuncts to conventional antihyperglycemic therapies.
Citation: "Managing Type 2 Diabetes: Balancing HbA1c and Body Weight " Postgrad Med 2010 May 122(3):106-117.
Summary: Attempts at managing type 2 diabetes in the obese are often sabotaged by weight gain as a side effect of therapy. Weight loss has been shown to improve insulin resistance, improve glycemic control, and decrease the need for medication. Appropriate choice of medications in this population can help minimize weight gain and perhaps lead to weight loss, thus improving glycemic control and hopefully leading to improvements in overall cardiovascular risk. This review revealed that the antihyperglycemic agents most likely to be weight neutral or to promote loss were the biguanides (e.g. metformin), α-glucosidase inhibitors (e.g. acarbose), incretin mimetics (e.g. exenatide), amylin mimetics (e.g. pramlintide), DPP4-inhibitors (e.g. sitagliptin/saxagliptin). In addition, providers may consider the use of orlistat and sibutramine to target weight loss as adjuncts to conventional antihyperglycemic therapies.
Commentary: Further studies are needed to determine if these effects will translate into clinically relevant improvements in CV outcomes.
By: Sue Kim MD
By: Sue Kim MD
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