Which Diabetes Medication May Lead to Weight Loss?

Although less discussed than other chronic diseases, obesity is actually the mother of all diseases. Adults are considered obese when their body mass index (BMI) exceeds a certain cutoff value. For Indians, the cutoff in kg/m2 is 23-24.9 for ‘overweight’ and 25 for ‘obese’. A waist circumference of 80 cm for women and 90 cm for men is considered high. Some people use waist-to-hip ratio to define central obesity. World Health Organization figures show that obesity has increased exponentially around the world, tripling since 1975.

How Obesity Raises Diabetes Risk

There is a strong link between increasing obesity and type 2 diabetes, which operates on multiple levels. First, if you are overweight or obese, your risk of developing diabetes is greatly increased. His overall risk of developing diabetes is six times higher in an overweight person. In a British study, a group with an average BMI of 34.5 was associated with a 12-fold higher risk for him than the lean group. So if you’re looking to prevent diabetes, watch your waist! Second, in diabetics, obesity makes blood sugar levels more difficult to control and gradually increases the need for medication. Third, obesity exacerbates diabetes complications. For example, having obesity with diabetes in addition to just one of these conditions increases the risk of heart attack.

Numerous studies have shown that weight loss has a positive impact on all of the above conditions. It can reduce your chances of developing diabetes, simplify diabetes management, and reduce your risk of complications. Rather, losing weight in the early stages of diabetes, especially in younger people, frees them from medications that induce remission or recovery of symptoms.

That brings us to the million dollar question: How do you lose weight? Everyone knows that losing weight is a very difficult and often very frustrating task. You’ll agree. The key to weight loss is lifestyle changes, which essentially means diet and exercise. Both of these involve behavior modification, which is difficult to implement and even more difficult to maintain. Bariatric surgery is an option for those with diabetes who meet the criteria. But what about drugs? Unfortunately, some of the traditional diabetes medications (such as sulfonylureas, thiazolidinediones, and insulin) are associated with weight gain rather than weight loss. Other products like Gliptins (DPP4i) are weight neutral. Metformin is the only conventional drug associated with weight loss, but its effect is small.

what’s the good news?

Over the last decade or so, there has been a paradigm shift in the treatment of diabetes. This has been made possible by the discovery of new classes of drugs such as SGLT2 inhibitors and his GLP1 receptor agonists. SGLT2 inhibitors are oral drugs and are freely available in India (Dapagliflozin, Empagliflozin, Canagliflozin, Remogliflozin). Eliminates glucose through the urine, does not cause hypoglycemic reactions, and aids in weight loss. Typical weight loss with these agents ranges from 2 to 3 kg. This may not seem like a big deal, but it is important in terms of health benefits as it makes diabetes easier to manage and reduces the risk of complications. By acting directly on these organs, it reduces the risk of heart failure, heart attack, and kidney failure.

Another group of antidiabetic drugs that induce weight loss while lowering blood sugar levels are the “GLP1 RAs” such as liraglutide, dulaglutide, and now semaglutide. daily, weekly). GLP1 RA acts to lose weight primarily through its effects on the brain, reducing appetite and causing a feeling of satiety. The resulting weight loss is slightly greater than that seen with SGLT2 inhibitors, often in the range of 2-4 kg, but with considerable individual variability. The greatest challenge in using these molecules has been the need for injection. This problem was circumvented with the availability of oral semaglutide in India.

As impressive as the data are, the weight loss effects of these drugs when used alone are best described as moderate. You can see a decrease.

Was it disappointing? Well, there’s even better news. Although not yet available in India, in people without diabetes, injectable semaglutide administered at a dose of 2.4 mg weekly (as opposed to oral available in India) resulted in an average weight loss of 15 kg over 7 months. can result in The numbers for diabetics are slightly lower.

Most participants (70% to 80%) lose 5% or more of their body weight. As if this wasn’t enough, weekly injections of 15 mg of the dual GIP/GLP-1 RA agonist tirzepatide (also not yet available in India) and 2 mg of semaglutide.

The problem of not regaining weight

This level of weight loss, caused primarily by something developed as a diabetes drug, would have been unimaginable even five years ago. However, unless individuals are trained in diet and exercise, weight recovery upon cessation of treatment remains a challenge. helps to combat