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.
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- Diabetes drugs ride a bumpy road.Nature. 2013; 504: 198
- Impact of sodium glucose cotransporter 2 inhibitors on weight in patients with type 2 diabetes mellitus.Postgrad. Med. 2013; 125: 92-100
- Adherence to therapies in patients with type 2 diabetes.Diabetes Ther. Res. Treat. Educ. Diabetes Relat. Disord. 2013; 4: 175-194
- 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
- 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
- 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
- Pharmacologic therapy for cardiovascular risk reduction in patients with the metabolic syndrome.Curr. Pharm. Des. 2013; ([Epub ahead of print])
- Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus.Cochrane Database Syst. Rev. 2008; : CD006739https://doi.org/10.1002/14651858.CD006739.pub2
- 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
- Newer agents for blood glucose control in type 2 diabetes: systematic review and economic evaluation.Health Technol. Assess. Winch Engl. 2010; 14: 1-248
- 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
- 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])https://doi.org/10.1111/dom.12253
- 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
- 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
- Glycemic control continues to deteriorate after sulfonylureas are added to metformin among patients with type 2 diabetes.Diabetes Care. 2005; 28: 995-1000
- 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
- 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
- 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
- Metabolic response to sodium-glucose cotransporter 2 inhibition in type 2 diabetic patients.J. Clin. Invest. 2014; 124: 499-508
Published online: May 06, 2014
Accepted: April 1, 2014
Received in revised form: March 27, 2014
Received: February 8, 2014
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.