Patients with type 2 diabetes who were prescribed SGLT2 inhibitors lost more weight than those who received GLP-1 receptor agonists, according to a study conducted by the University at Buffalo.
Research that sought to evaluate the difference in weight loss from the antidiabetic drugs – both of which work to control blood sugar levels – found that 72 patients who used SGLT2 inhibitors had an average weight loss of more than 6 pounds, while those who received 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 a beneficial property of diabetes medication because obesity is a common feature of the disease and can ultimately lead to decreased insulin sensitivity. By losing weight, it is possible to regain insulin sensitivity, improve blood sugar control, and reduce cardiac risk factors and comorbidities. “
Nicole Paolini Albanese, Study Director, PharmD, Clinical Associate Professor of Pharmacy Practice in the School of Pharmacy and Pharmaceutical Sciences, University at Buffalo
Both SGLT2 inhibitors and GLP-1 receptor agonists are recommended as second-line therapies for type 2 diabetes after taking metformin, a drug that is also prescribed to control blood sugar, Albanese says.
The study examined records of patients with type 2 diabetes who received either SGLT2 inhibitors or GLP-1 receptor agonists in addition to other diabetes drugs from 2012 to 2017. The researchers measured weight loss after six months of consecutive therapy, as well as differences in blood pressure, blood sugar levels, 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 widely prescribed GLP-1 receptor agonist.
No significant differences were found in blood pressure, blood sugar levels and kidney function after taking the medication. The data suggest that SGLT2 inhibitors may protect against weight gain from other antidiabetic drugs better than GLP-1 receptor agonists, says Albanese. The results also contradict previous research that found GLP-1 receptor agonists to be the superior antidiabetic drug for weight loss, she says.
Although the weight loss caused by the drugs is small, the results warrant larger research examining the effects 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 discourage discussion of these potential benefits, as even slight weight loss is a unique benefit of these drugs, especially when compared to potential weight gain from other treatment options.”
Frieling, K., et al. (2021) Weight loss differences between glucagon-like-peptide-1 (GLP-1) receptor agonists and sodium glucose cotransporter-2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Journal of the American Pharmacists Association. doi.org/10.1016/j.japh.2021.06.015.