Year: 2025
Type: dissertation
Abstract: Overweight or obese patients with diabetes are diseases linked together that over last decades reached to high alarming state that increased health metabolic issues and mortality worldwide. The key steps in the management of overweight or obesity in type 2 diabetes mellitus are lifestyle changes, diet, physical activity and pharmacological agents like appetite suppressants, thermogenics, Mediterranean diet, ketogenic diet, medical devices and bariatric surgeries. In order to analyse positive effects, weight loss efficacy, glycaemic control, we discussed academic and scientific articles that have been published for each agent. There are several anti-hyperglycaemic agents that can help in weight loss, weight gain and weight neutral. Biguanides (Metformin) showed moderate weight loss effect. Dipeptidyl peptidase-4 inhibitors showed neutral or mild weight loss effect, including: Sitagliptin (mild), Vildagliptin (neutral), Saxagliptin (neutral), Linagliptin (neutral), Alogliptin (neutral). Sodium/glucose cotransporter 2 protein inhibitors showed modest to moderate weight loss effect, including: Canagliflozin (moderate), Dapagliflozin (moderate), Empagliflozin (moderate), Ertugliflozin (moderate), Bexagliflozin (mild-moderate). Glucagon-like Peptide-1 hormone receptor agonists have greatest and strongest weight loss effects, including: Exenatide (moderate), Liraglutide (strong, Federation Diabetes Association-approved for obesity), Dulaglutide (mild-moderate), Lixisenatide (mild), Subcutaneous Semaglutide (moderate-strong, Federation Diabetes Association-approved for obesity), Oral Semaglutide (Federation Diabetes Association-approved for obesity), Tirzepatide (strongest with high efficacy and safety). Alpha-Glucosidase Inhibitors include Acarbose (mild) and Miglitol (neutral) weight loss effect. Amylin Analogous like Pramlintide showed moderate weight loss effect, Bile Acid Resins sequestrants like Colesevelam showed neutral weight loss effect. Centrally acting Sympatholytics Dopamine-2 Agonist like Bromocriptine Mesylate showed mild weight loss effect, Serotonin Receptor Agonist like Lorcaserin showed moderate weight loss effect. Melanocortin 4 Receptor Agonist like Setmelanotide showed strong weight loss effect, Sympathomimetic Amine Anorectic Agent like Phentermine showed modest weight loss effect. Lipase Inhibitor like Orlistat showed moderate weight loss effect, Sympathomimetic Amine Anorectic Agent/Antiepileptic combination like Phentermine/Topiramate Extended Release showed strong weight loss effect. Opioid Antagonist/Antidepressant combination like Naltrexone/Bupropion Extended Release showed moderate to strong weight loss effect. There are several medical devices that help the patients with overweight or obesity to decrease weight: Intra-gastric Balloons, Electrical stimulation systems, Gastric emptying systems, Endoscopic Endo-luminal Bypass liners, Hydrogel Particle. The most effective long-term treatment in patients with overweight or obesity and type 2 diabetes mellitus is bariatric surgery and it includes: Roux-en-Y (Roux-en-Y Gastric Bypass), Adjustable Gastric Band (Adjustable Gastric Band), Biliopancreatic Diversion with Duodenal Switch (Biliopancreatic Diversion with Duodenal Switch), Single Anastomosis Duodenal Ileostomy with sleeve Gastrectomy (Single Anastomosis Duodenal Ileostomy with sleeve Gastrectomy), One Anastomosis Gastric Bypass (One Anastomosis Gastric Bypass).
Author: Jamali, Kamal
Language: English
Subfield: Pharmacology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: American Diabetes Association
OpenAlex ID: W7132089968