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1 . 2022

Influence of modern antidiabetic therapy on body weight in patients with type 2 diabetes mellitus


Obesity is one of the main risk factors for type 2 diabetes mellitus (T2DM) and is a major healthcare system challenge. Moderate weight loss (≥5% but <10%) can minimize and reduce complications associated with T2DM, and significant weight loss can even predetermine remission of the disease. The bi-directional relationship between obesity and T2DM is also manifested in the fact that hyperinsulinemia, insulin resistance, in turn, can determine body weight gain in patients with diabetes meltitus. An increase in the volume of visceral and ectopic fat determines not only an increase in insulin resistance, and, as a consequence, an escalation of antidiabetic therapy, but also an increase in cardiovascular risk. Modern antidiabetic therapy has a significant effect on patient weight, prompting careful selection of T2DM management tools. Metformin to a lesser extent, inhibitors of sodium glucose co-transporter type 2 (SGLT2i) and agonists of glucagon-like peptide-1 receptors (GLP-lRa) - to a greater extent reduce the body weight of patients. Dipeptidyl peptidase-4 inhibitors and fixed ratio insulin/GLP-lRa combination therapy appear to have a neutral effect on weight. Insulin secretagogues - sulfonylurea derivatives, meglitinides and insulins lead to weight gain and are associated with a higher risk of severe hypoglycemia due to hyperinsulinemia, making them less suitable for the treatment of obese patients. Somewhat apart are thiazolidinediones, which increase body weight through subcutaneous fat and fluid retention, but decrease visceral fat, thus improving the metabolic profile of patients.

Keywords:type 2 diabetes mellitus; obesity; antidiabetic drugs; antiobesity drugs

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Salukhov V.V., Ilyinskaya T.A., Minakov A.A. Influence of modern antidiabetic therapy on body weight in patients with type 2 diabetes mellitus. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (1): 39-52. DOI: (in Russian)

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Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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