Various Treatments Yield Sustained Reductions in Body Weight, Blood Pressure

Semaglutide and sodium-glucose co-transporter-2 (SGLT-2) inhibitors reduced body weight as well as blood pressure over a year of treatment in patients with type 2 diabetes, according to a meta-analysis published in Diabetes, Obesity and Metabolism.

"These agents may be preferable treatment options for patients with type 2 diabetes who are overweight/obese and/or hypertensive," researchers wrote.

The systematic review and network meta-analysis compared the effects of 21 glucose-lowering medications on body weight and blood pressure in adults with type 2 diabetes. The investigation included 424 randomized controlled trials that lasted at least 24 weeks and included 276,336 patients.

For reducing body weight, subcutaneous semaglutide was the most effective, according to the study. Oral semaglutide, twice-daily exenatide, liraglutide, and the SGLT-2 inhibitors empagliflozin, canagliflozin, dapagliflozin, and ertugliflozin were also effective for weight loss.

Those same medications demonstrated the greatest effects for reducing systolic blood pressure as well. Meanwhile, SGLT-2 inhibitors, pioglitazone, twice-daily exenatide, and semaglutide reduced diastolic blood pressure, researchers reported.

The effect of metformin for reducing body weight and systolic blood pressure was modest.

"In subgroup analyses of trials with over 52?weeks' duration," researchers wrote, "semaglutide and SGLT-2 inhibitors reduced both body weight and systolic blood pressure."

Reference:
Tsapas A, Karagiannis T, Kakotrichi P, et al. 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. Diabetes Obes Metab. 2021;23(9):2116-2124. doi:10.1111/dom.14451