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Comparative Effects of Antidiabetic Drugs on Body Composition: A Systematic Review and Network Meta-Analysis
Seyedeh Samira Rakhsha1,2, Hossein Shahinfar3, Sara Ebrahimi-Mousavi4,5
1Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Diabetes, Obesity & Metabolism
|June 16, 2026
Summary
Glucagon-like peptide-1 (GLP-1) and dual GLP-1/GIP receptor agonists significantly reduce fat mass but also lean body mass. Exercise can mitigate lean mass loss. Other antidiabetic drugs have minimal effects on body composition.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Antidiabetic drugs impact body composition, influencing metabolic and functional health.
- Understanding these effects is crucial for optimizing patient outcomes.
Conclusions:
- GLP-1 and dual GLP-1/GIP receptor agonists are most effective for fat mass reduction but can decrease lean mass.
- Exercise interventions can counteract lean body mass loss associated with certain antidiabetic drugs like liraglutide.
- SGLT2 inhibitors offer modest body composition benefits, whereas metformin, insulin, DPP4 inhibitors, and sulfonylureas have minimal impact.
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