Research
Hormonal
GLP-1 receptor agonists and SGLT2 inhibitors are preferred glucose-lowering medications for obese diabetic patients because they promote weight loss (5.3 kg and 2.4 kg respectively), whereas sulfonylureas, TZDs, and insulin promote weight gain.
If you are taking diabetes medication and struggling with weight, ask your doctor about switching to GLP-1 agonists (like semaglutide or liraglutide) or SGLT2 inhibitors (like empagliflozin), which help you lose weight. Avoid medications like insulin, sulfonylureas, or TZDs if possible, as they tend to cause weight gain.
GoodSupportsHIGH confidence
First, clinicians should consider using the following glucose-lowering medications that are weight neutral or may promote weight loss: metformin, pramlintide, glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium–glucose cotransporter 2 (SGLT2) inhibitors... GLP-1 receptor agonists have been associated with a 5.3-kg weight loss (58)... SGLT2 inhibitors can promote a 2.4-kg weight loss... avoiding diabetes medications that are associated with weight gain (e.g., sulfonylureas, thiazolidinediones, and insulin)
Why this rating
Supported by specific drug trials cited in the text (e.g., Klonoff for GLP-1, Rosenstock for SGLT2).
Source
Treatment of Obesity in Patients With Diabetes
Carolyn T. Bramante et al. · Diabetes Spectrum · 2017
DOI 10.2337/ds17-0030
narrative_reviewCited 95×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Modest weight loss of 5-10% of baseline body weight significantly improves glycemic control (A1C reduction of 0.6-1.0%) and reduces the need for diabetes medications.Strong
- A caloric deficit of 500–750 kcal/day is the primary driver of weight loss in patients with diabetes, whereas exercise alone is insufficient for initial loss but critical for maintenance.Good
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
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →