Hormonal
Subcutaneous semaglutide and SGLT-2 inhibitors (empagliflozin, canagliflozin, dapagliflozin, ertugliflozin) produce the greatest reductions in body weight and systolic blood pressure in patients with type 2 diabetes compared to other glucose-lowering medications.
For patients with type 2 diabetes seeking to lose weight and lower blood pressure, subcutaneous semaglutide and SGLT-2 inhibitors (like empagliflozin or canagliflozin) are the most effective pharmacological options. These drugs offer sustainable benefits over long-term treatment (>= 1 year) and may reduce the need for separate antihypertensive or lipid-lowering medications.
Subcutaneous semaglutide was the most efficacious in reducing body weight followed by oral semaglutide, exenatide twice-daily, liraglutide, and the sodium-glucose co-transporter-2 (SGLT-2) inhibitors empagliflozin, canagliflozin, dapagliflozin and ertugliflozin. The same agents also conferred the greatest reductions in systolic blood pressure.
Why this rating
Network meta-analysis of 424 trials involving 276,336 patients with high-to-moderate confidence (CINeMA).
Source
Comparative efficacy of glucose‐lowering medications on body weight and blood pressure in patients with type 2 diabetes: A systematic review and network meta‐analysis
Απόστολος Τσάπας et al. · Diabetes Obesity and Metabolism · 2021
DOI 10.1111/dom.14451
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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