Understanding the impact of commonly utilized, non-insulin, glucose-lowering drugs on body weight in patients with type 2 diabetes

Expert Opin Pharmacother. 2018 Jul;19(10):1087-1095. doi: 10.1080/14656566.2018.1494727. Epub 2018 Jul 11.


Introduction: The majority of patients with type 2 diabetes also have obesity. Obesity increases the risk of developing diabetes and is associated with worsened glycemic control and increased morbidity and mortality in individuals with diabetes. Sustained weight loss is associated with improved glycemic control, potential for diabetes remission, and decreased medical expenditures.

Areas covered: Herein, the impact of commonly utilized, non-insulin, glucose-lowering drugs on body weight in patients with type 2 diabetes is discussed. The weight change magnitudes, mechanisms, and any within-class differences are also explored.

Expert opinion: The weight impact of diabetes medications should be considered when designing treatment regimens, especially in patients who are overweight or have obesity. Lifestyle modification is paramount for optimal diabetes management. Therapeutic regimens should ideally be designed to maximize weight loss and at least minimize or avoid weight gain. Future glucose-lowering medications should continue to offer improvement in cardiovascular risk factors, including weight, in order to be accepted into the armamentarium of diabetes therapy. Therapeutic regimens should be designed to help patients with diabetes and obesity achieve both glycemic and weight goals. Management of these disease states is expected to become increasingly integrated.

Keywords: Body weight; dipeptidyl peptidase-4 inhibitor; glucagon-like peptide 1-receptor agonist; metformin; obesity; pharmacotherapy; sodium glucose cotransporter-2 inhibitor; sulfonylurea; thiazolidinedione; type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Benzhydryl Compounds / pharmacology
  • Benzhydryl Compounds / therapeutic use
  • Body Weight* / drug effects
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / pathology
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Exenatide
  • Glucagon-Like Peptide-1 Receptor / agonists
  • Glucagon-Like Peptide-1 Receptor / metabolism
  • Glucosides / pharmacology
  • Glucosides / therapeutic use
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use*
  • Metformin / pharmacology
  • Metformin / therapeutic use
  • Peptides / pharmacology
  • Peptides / therapeutic use
  • Sodium-Glucose Transporter 1 / antagonists & inhibitors
  • Sodium-Glucose Transporter 1 / metabolism
  • Venoms / pharmacology
  • Venoms / therapeutic use


  • Benzhydryl Compounds
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glucagon-Like Peptide-1 Receptor
  • Glucosides
  • Hypoglycemic Agents
  • Peptides
  • Sodium-Glucose Transporter 1
  • Venoms
  • Metformin
  • Exenatide
  • empagliflozin