4.2.0.0 Antihy­per­glycemia Ther­a­py

Agents as­so­ci­at­ed with vary­ing de­grees of weight loss in­clude met­formin, α-‍glu­cosi­dase in­hibitors, sodi­um–glu­cose co­trans­porter 2 in­hibitors, glucagon-‍like pep­tide 1 re­cep­tor ag­o­nists, and amylin mimet­ics. Dipep­tidyl pep­ti­dase 4 in­hibitors are weight neu­tral. Un­like these agents, in­sulin sec­re­t­a­gogues, thi­a­zo­lidine­diones, and in­sulin often cause weight gain (see Sec­tion 9 “Phar­ma­colo­gic Ap­proach­es to Glycemic Treat­ment”).

A re­cent meta-‍anal­y­sis of 227 ran­dom­ized con­trolled tri­als of antihy­per­glycemia treat­ments in type 2 di­a­betes found that A1C changes were not as­so­ci­at­ed with base­line BMI, in­di­cat­ing that pa­tients with obe­si­ty can benefit from the same types of treat­ments for di­a­betes as nor­mal-‍weight pa­tients (39).