Diabetic medication leads to twice the weight loss of its competitor in patients with type 2 diabetes

BUFFALO, NY – Patients with type 2 diabetes who were prescribed SGLT2 inhibitors lost more weight than patients who received GLP-1 receptor agonists, according to a study conducted by the University of Buffalo .

The research, which aimed to assess the difference in weight loss caused by diabetes drugs – both of which work to control blood sugar – found that among 72 patients, people using SGLT2 inhibitors experienced a median weight loss of over 6 pounds, while those on GLP-1 receptor agonists lost a median of 2.5 pounds.

The results, published last month in the Journal of the American Pharmacists Association, represent one of the first attempts to compare the two drugs.

“Weight loss is an advantageous quality for diabetic drugs because being overweight is a common feature of the disease and can eventually lead to reduced insulin sensitivity,” said lead author Nicole Paolini Albanese, PharmD, Clinical associate professor of pharmaceutical practice at the UB School of Pharmacy and Pharmaceutical Sciences. “With weight loss, it is possible to regain insulin sensitivity, improve blood sugar control, and reduce cardiac risk factors and co-morbidities. “

SGLT2 inhibitors and GLP-1 receptor agonists are both recommended as second-line therapies for type 2 diabetes after using metformin, a drug also prescribed to control blood sugar, says Albanese.

The study looked at the records of patients with type 2 diabetes who received SGLT2 inhibitors or GLP-1 receptor agonists, in addition to other diabetes medications, from 2012 to 2017. The researchers have measured weight loss after six consecutive months of treatment, as well as differences in blood pressure, blood sugar and kidney function.

Canagliflozin, sold under the brand name Invokana, was the most commonly prescribed SGLT2 inhibitor. Liraglutide, sold under the brand name Victoza, was the most commonly prescribed GLP-1 receptor agonist.

No significant differences were found in blood pressure, blood sugar, and kidney function after using the drugs. The data suggests that SGLT2 inhibitors may be more protective against weight gain caused by other diabetes drugs than GLP-1 receptor agonists, says Albanese. The results also contradict previous research which showed GLP-1 receptor agonists to be the superior diabetes drug for weight loss, she says.

Although the weight loss caused by the drugs is small, the results support larger investigations that are examining the effect of the drugs on weight, she says.

“These drugs in doses approved for the treatment of type 2 diabetes are not intended for weight loss,” says Albanese. “However, this should not deter discussion of this potential benefit, as even small weight loss is a unique benefit of these drugs, especially over the potential weight gain caused by other treatment options.”

Katherine Frieling, PharmD, clinical pharmacy specialist at Jackson-Madison County General Hospital in Jackson, Tennessee is the first author. Additional investigators at the UB School of Pharmacy and Pharmaceutical Sciences include Scott Monte, PharmD, clinical assistant professor of pharmacy practice; and David Jacobs, PharmD, PhD, assistant professor of pharmacy practice.