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Weight considerations in pharmacotherapy for type 2 diabetes
Vicky Cheng1, Sangeeta R Kashyap
1Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Journal of Obesity
|October 2, 2010
Summary
Managing type 2 diabetes in obese patients is challenging, as some medications cause weight gain. This review examines antidiabetes and antiobesity agents, highlighting their effects on weight and glycemic control.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Rising global obesity rates significantly impact type 2 diabetes prevalence.
- Obesity complicates diabetes management due to associated weight gain from certain antidiabetic medications.
- Obesity exacerbates insulin resistance, beta-cell dysfunction, and cardiovascular risks in diabetic patients.
Purpose of the Study:
- To review the effects of various antidiabetes and antiobesity agents on glycemic control and body weight.
- To inform clinical practice regarding medication choices for type 2 diabetes in overweight/obese individuals.
Main Methods:
- Literature review of antidiabetic and antiobesity medications.
- Analysis of effects on body weight and glycemic control.
Main Results:
- Sulfonylureas, thiazolidinediones, and insulin are linked to weight gain.
- Metformin and amylin analogs are weight-neutral or promote modest weight loss.
- Dipeptidyl-peptidase-4 inhibitors are weight-neutral; glucagon-like peptide-1 analogs promote weight loss.
- Orlistat and sibutramine effects in type 2 diabetes were also evaluated.
Conclusions:
- Diabetes treatment must consider both glycemic control and weight management.
- Medication selection should account for individual patient weight status and medication-induced weight changes.
- Integrated management of obesity and type 2 diabetes is crucial for improving patient outcomes and reducing cardiovascular risk.
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