Hormonal
GLP-1 receptor agonists produce significant weight loss (average 1.5–3 kg) in patients with type 2 diabetes, whereas DPP-4 inhibitors have a neutral effect on body weight.
If you have type 2 diabetes, GLP-1 receptor agonists (like liraglutide or exenatide) are likely to help you lose 1.5–3 kg, which is a modest but clinically relevant benefit. DPP-4 inhibitors (like sitagliptin) will not help you lose weight, but they also won't make you gain it. The choice depends on your specific health profile and preference for oral vs. injectable medication.
In summary, weight loss observed among GLP-1 receptor agonists has been similar, on average ranging from 1.5 to 3 kg... Overall, the effects DPP-4 inhibitors have on body weight appear to be neutral.
Why this rating
Based on multiple RCTs and meta-analyses cited, though clinical significance of small weight changes is noted.
Source
Implications of incretin-based therapies on cardiovascular disease
Melissa E. Rotz et al. · International Journal of Clinical Practice · 2014
DOI 10.1111/ijcp.12572
More from this paper
- GLP-1 receptor agonists reduce systolic blood pressure by 2–5 mmHg and diastolic blood pressure by 1–3 mmHg, with effects more pronounced than DPP-4 inhibitors.Good
- Saxagliptin (a DPP-4 inhibitor) is associated with an increased signal of hospitalizations for heart failure (HF), warranting vigilance in high-risk patients.Moderate
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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