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The Impact of Glucagon-Like Peptide 1 Receptor Agonists on Weight Reduction

Jul 10, 2015

GLP-1 agonists have additional benefits for type 2 diabetes besides lower blood glucose…

Over 1.4 billion adults were overweight in 2008, and of the 1.4 billion people, 500 million were obese. Obesity is defined as a body mass index >30 g/m2. Also, obesity increases the chance of being diagnosed with type 2 diabetes mellitus. There are approximately 347 million people faced with the challenges of diabetes every day. Weight loss is a major intervention for patients with type 2 diabetes. Patients with type 2 diabetes are advised to engage in lifestyle modification to elicit weight loss, however weight loss is often not achieved through sedentary changes. The first line therapy for type 2 diabetes is metformin. If additional medication is needed for glycemic control, then sulfonylureas, thiazolidinediones, GLP-1 receptor agonists, and DPP-IV inhibitors can be added as well. Previous studies have shown that GLP-1 agonists can lead to weight loss in obese or overweight patients with type 2 diabetes.

This study was designed as a systematic review and comparison meta-analysis. The researchers investigated randomized controlled trials which observed a comparison of GLP-1 agonist therapy against a placebo in patients with type 2 diabetes. This meta-analysis reviewed 27 randomized controlled trials. The meta-analysis was conducted to evaluate the change in weight loss at six months between the GLP-1 agonist medications and the placebos.

The results from the 27 randomized controlled trials showed that GLP-1 agonists contributed to the most weight loss. Exenatide 2mg/week showed 1.62kg of weight loss (95% CrI: -2.95kg, -0.30kg). Exenatide 20 ug showed 1.37kg of weight loss (95% CI: -222kg, -0.52kg). Liraglutide 1.2mg showed 1.01kg of weight loss (95%CrI: -2.41kg, 0.38kg). Liraglutide 1.8mg showed 1.51 kg of weight loss (95% CI: -2.67kg, -0.37kg). All of these agents were compared to placebo. Also, this noted that there was no statistical difference between the different GLP-1 agonists in terms of weight loss.

Practice Pearls:

  • Weight reduction can lead to decrease progression of insulin resistance in patients with type 2 diabetes.
  • Clinically relevant doses of GLP-1 agonist is associated with weight loss in patients with type 2 diabetes
  • Patients who are taking exenatide and liraglutide will experience similar weight loss.

Potts JE, Gray LJ, Brady EM, Khunti K, Davies MJ, Bodicoat DH. The Effect of Glucagon-Like Peptide 1 Receptor Agonists on Weight Loss in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison Meta-Analysis. PLoS ONE. 2015;10(6):e0126769.