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Comparing Medications for Adults With Type 2 Diabetes

Slide: 16 of 35

Intermediate Outcomes: Overview of Weight Results

Diabetes medications varied in their effects on body weight. Weight change was small to moderate, generally less than 2 kg, between baseline and final values. However, even small amounts of weight gain (5 percent to 10 percent of body weight) may be associated with increased insulin resistance. Metformin consistently had a more favorable effect on weight when compared with other diabetes medications such as thiazolidinediones, sulfonylureas, and DPP-4 inhibitors. Although placebo-controlled trials of metformin were excluded from this review, the 2007 evidence report showed that metformin was associated with weight neutrality when compared with placebo. As compared with sulfonylureas, the GLP-1 receptor agonists were associated with a relative weight change of about -2.5 kg, with a moderate strength of evidence. Metformin plus second-generation sulfonylureas are associated with less weight gain than are combinations with TZDs (moderate strength of evidence). Some newer agents in combination show promise for lower levels of weight gain (low strength of evidence). The UKPDS, while consistent with the above meta-analysis, was excluded from this section of the report since they were allowed to add other diabetes medications to their initial monotherapy groups.