Management of type 2 diabetes mellitus in overweight patients: an updated review

What is it about?

A brief overview of recent publications on sugar-lowering drugs that can be used in type 2 diabetes with overweight patients is presented. The effect of drugs on body weight and beta cell function, as well as relative cost of the treatment is discussed. Special attention is paid to the following groups of medicines. Glucagon-like peptide 1 receptor agonists stimulate the secretion of insulin, lowering appetite and the gastrointestinal motility, thus promoting weight loss. The relatively high cost of glucagon-like peptide 1 receptor agonists and subcutaneous administration are pointed out. Oral semaglutide is the only glucagon-like peptide 1 receptor agonist preparation used for the oral intake. Sodium-glucose cotransporter 2 inhibitors reduce renal glucose reabsorption, excrete glucose in the urine, lower blood pressure, and promote weight loss. Glycemic control is thus maintained in the long term. Weight loss can also be expected from intestinal alpha-glucosidase inhibitors (acarbose), which inhibit the digestion and absorption of complex carbohydrates in the intestine. The hypoglycemic effect of the drugs of last two groups (as well as metformin) is not associated with the stimulation beta cells, which can be depleted by prolonged stimulation. Combination therapy using sugar-lowering and anorexigenic drugs is discussed.

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