Hormonal
SGLT-2 inhibitors and GLP-1 RAs provide sustainable reductions in body weight and systolic blood pressure for over 52 weeks of treatment, unlike some other agents where effects may diminish.
For long-term management of type 2 diabetes, GLP-1 RAs and SGLT-2 inhibitors are preferred because their benefits on weight and blood pressure are sustained over a year or more. This makes them suitable for patients who need durable control without the weight gain associated with other medications like insulin or sulphonylureas.
In subgroup analyses of trials with over 52 weeks' duration, semaglutide and SGLT-2 inhibitors reduced both body weight and systolic blood pressure.
Why this rating
Subgroup analysis of 124 trials with mean duration 98 weeks.
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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