Study: Patients With Type 2 Diabetes Prescribed SGLT2 Inhibitors Lose More Weight Than Those Prescribed GLP-1 Receptor Agonists

Individuals with type 2 diabetes who were prescribed sodium-glucose cotransporter-2 (SGLT2) inhibitors lost significantly more weight than those who were prescribed glucagon-like peptide 1 (GLP-1) receptor agonists, according to the findings of a new study.

Investigators aimed to evaluate the differences in weight loss caused by SGLT2 inhibitors and GLP-1 receptor agonists, both of which are frequently prescribed for type 2 diabetes. Among 72 patients, individuals receiving SGLT2 inhibitors experienced a median weight loss of more than 6 pounds, compared to a median of 2.5 pounds among those receiving GLP-1 receptor agonists.

Both SGLT2 inhibitors and GLP-1 receptor agonists are indicated as second-line therapies for type 2 diabetes after the use of metformin, which is also prescribed to control blood sugar. The new study findings were published in June in the Journal of the American Pharmacists Association and represent one of the first attempts to compare the 2 drugs, according to the authors.

“Weight loss is an advantageous quality for diabetic medications, as being overweight is a common characteristic of the disease and can eventually lead to reduced insulin sensitivity,” said lead author Nicole Paolini Albanese, PharmD, a clinical associate professor in the University at Buffalo School of Pharmacy and Pharmaceutical Sciences, in a press release. “With weight loss, it is possible to regain insulin sensitivity, improve glucose control, and reduce heart risk factors and comorbidities.”

Investigators analyzed medical records for patients with type 2 diabetes who received either SGLT2 inhibitors or GLP-1 receptor agonists, in addition to other diabetes medications, from 2012 to 2017. They measured weight loss after 6 months of consecutive therapy, as well as differences in blood pressure, blood sugar levels, and kidney function.

Canagliflozin was the most commonly prescribed SGLT2 inhibitor and liraglutide was the most commonly prescribed GLP-1 receptor agonist, according to the study. No significant differences were found in blood pressure, blood sugar levels, or kidney function after use of the medications. The findings suggest that SGLT2 inhibitors may be more protective against weight gain caused by other antidiabetic drugs than GLP-1 receptor agonists, Albanese said in the press release.

The findings also go against earlier research, which has found that GLP-1 receptor agonists are the superior antidiabetic drug for weight loss, according to the study authors. They added that although the weight loss caused by the drug is small, the study results warrant larger investigations that examine the medications’ impact on weight.

“These medications at doses approved for treating type 2 diabetes are not intended for weight loss,” Albanese said in the press release. “However, this should not discourage the discussion of this potential benefit, as even a small amount of weight loss is a unique advantage of these drugs, especially when compared to potential weight gain caused by other treatment options.”

REFERENCE

Antidiabetic drug causes double the weight loss of competitor in type 2 diabetes patients. News release. University at Buffalo. July 1, 2021. Accessed July 6, 2021. http://www.buffalo.edu/news/releases/2021/07/001.html