Brief report| Volume 9, ISSUE 1, P74-77, February 2015

Download started.


Effects of selected antidiabetics on weight loss – A retrospective database analysis



      In published studies metformin was often associated with weight loss in type 2 diabetes patients. Until now, no epidemiological studies have directly compared the effects of DPP-4 and GLP-1 versus metformin on weight loss. Our study is a comparison of sulfonylurea, DPP-4 and GLP-1 with metformin regarding body weight in type 2 diabetes patients.


      Data from 2641 patients initiated therapy with either metformin, sulfonylurea, DPP-inhibitors or GLP-1 with baseline BMI >30 were retrospectively analyzed (Disease Analyzer Germany: 11/2008–10/2012). Comparison was performed for the weight change after 1 year of therapy compared with the last value prior to therapy. Differences between SU, DPP-4, GLP-1 versus metformin were estimated using regression model adjusted for age, gender, health insurance status, defined co-diagnoses and body weight at baseline.


      In absolute values, metformin patients lost an average of 2.6 kg, subjects treated with SU gained 0.3 kg, body weight in the DPP-4 group decreased by 1.8 kg and GLP-1 patients lost 3.3 kg in body weight after 1 year. After adjustment for other variables, comparisons with metformin revealed the following results: SU +3.4 kg (p < 0.001), DPP-4 +1.0 kg (p = 0.003) and GLP-1 −0.4 kg (p = 0.589).


      Our study showed that GLP-1 treatment was comparable to metformin regarding the weight reduction, while sulfonylurea and DPP-4 are inferior in this regard.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Primary Care Diabetes
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ledford H.
        Diabetes drugs ride a bumpy road.
        Nature. 2013; 504: 198
        • Barnett A.H.
        Impact of sodium glucose cotransporter 2 inhibitors on weight in patients with type 2 diabetes mellitus.
        Postgrad. Med. 2013; 125: 92-100
        • García-Pérez L.-E.
        • Alvarez M.
        • Dilla T.
        • Gil-Guillén V.
        • Orozco-Beltrán D.
        Adherence to therapies in patients with type 2 diabetes.
        Diabetes Ther. Res. Treat. Educ. Diabetes Relat. Disord. 2013; 4: 175-194
        • Grandy S.
        • Fox K.M.
        • Hardy E.
        • SHIELD Study Group
        Association of Weight Loss and Medication Adherence Among Adults With Type 2 Diabetes Mellitus: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes).
        Curr. Ther. Res. Clin. Exp. 2013; 75: 77-82
        • Wang H.
        • Ni Y.
        • Yang S.
        • Li H.
        • Li X.
        • Feng B.
        The effects of gliclazide, metformin, and acarbose on body composition in patients with newly diagnosed type 2 diabetes mellitus.
        Curr. Ther. Res. Clin. Exp. 2013; 75: 88-92
        • McDonagh M.S.
        • Selph S.
        • Ozpinar A.
        • Foley C.
        Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger.
        JAMA Pediatr. 2014; 168: 178-184
        • Gouni-Berthold I.
        • Berthold H.K.
        Pharmacologic therapy for cardiovascular risk reduction in patients with the metabolic syndrome.
        Curr. Pharm. Des. 2013; ([Epub ahead of print])
        • Richter B.
        • Bandeira-Echtler E.
        • Bergerhoff K.
        • Lerch C.L.
        Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus.
        Cochrane Database Syst. Rev. 2008; : CD006739
        • Tricco A.C.
        • Antony J.
        • Soobiah C.
        • Hemmelgarn B.
        • Moher D.
        • Hutton B.
        • et al.
        Safety, effectiveness, and cost of dipeptidyl peptidase-4 inhibitors versus intermediate acting insulin for type 2 diabetes: protocol for a systematic review and network meta-analysis.
        Syst. Rev. 2013; 2: 47
        • Waugh N.
        • Cummins E.
        • Royle P.
        • Clar C.
        • Marien M.
        • Richter B.
        • et al.
        Newer agents for blood glucose control in type 2 diabetes: systematic review and economic evaluation.
        Health Technol. Assess. Winch Engl. 2010; 14: 1-248
        • Karagiannis T.
        • Paschos P.
        • Paletas K.
        • Matthews D.R.
        • Tsapas A.
        Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis.
        Br. Med. J. 2012; 344: e1369
        • Bolli G.B.
        • Owens D.R.
        Lixisenatide, a novel GLP-1 receptor agonist: efficacy, safety and clinical implications for type 2 diabetes mellitus.
        Diabetes Obes. Metab. 2013; ([Epub ahead of print])
        • Buse J.B.
        • Rosenstock J.
        • Sesti G.
        • Schmidt W.E.
        • Montanya E.
        • Brett J.H.
        • et al.
        Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6).
        Lancet. 2009; 374: 39-47
        • Buse J.B.
        • Bergenstal R.M.
        • Glass L.C.
        • Heilmann C.R.
        • Lewis M.S.
        • Kwan A.Y.M.
        • et al.
        Use of twice-daily exenatide in Basal insulin-treated patients with type 2 diabetes: a randomized, controlled trial.
        Ann. Intern. Med. 2011; 154: 103-112
        • Cook M.N.
        • Girman C.J.
        • Stein P.P.
        • Alexander C.M.
        • Holman R.R.
        Glycemic control continues to deteriorate after sulfonylureas are added to metformin among patients with type 2 diabetes.
        Diabetes Care. 2005; 28: 995-1000
        • Fiorentino T.V.
        • Sesti G.
        Effects of anti-diabetic therapy on overweight/obesity and dyslipidemia: traditional hypoglycemic agents (metformin, sulfonylureas, thiazolidinediones) versus glucagon-like peptide-1 analogs and dipeptidyl peptidase-4 inhibitors.
        G. Ital. Cardiol. 2013; 14: 15-25
        • Madsbad S.
        Exenatide and liraglutide: different approaches to develop GLP-1 receptor agonists (incretin mimetics) – preclinical and clinical results.
        Best Pract. Res. Clin. Endocrinol. Metab. 2009; 23: 463-477
        • Cuypers J.
        • Mathieu C.
        • Benhalima K.
        SGLT2-inhibitors: a novel class for the treatment of type 2 diabetes introduction of SGLT2-inhibitors in clinical practice.
        Acta Clin. Belg. 2013; 68: 287-293
        • Ferrannini E.
        • Muscelli E.
        • Frascerra S.
        • Baldi S.
        • Mari A.
        • Heise T.
        • et al.
        Metabolic response to sodium-glucose cotransporter 2 inhibition in type 2 diabetic patients.
        J. Clin. Invest. 2014; 124: 499-508