Abstract: PO1753
Weight Changes Following Diabetes Medication: A Population-Based Study
Session Information
- Health Maintenance, Nutrition, and Metabolism
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Authors
- Lyu, Beini, University of Wisconsin-Madison, Madison, Wisconsin, United States
- Grams, Morgan, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Inker, Lesley Ann, Tufts Medical Center, Boston, Massachusetts, United States
- Chang, Alex R., Geisinger Medical Center, Danville, Pennsylvania, United States
- Shin, Jung-Im, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
Background
The majority of patients with type 2 diabetes are obese, with greater percentages in those with concomitant CKD. Clinical trials suggest that the newer glucose-lowering medications, including sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor antagonists (GLP1RA), provide an added benefit of weight loss in people with type 2 diabetes. We evaluated the magnitude of weight change associated with diabetes medication prescription in real-world practice in persons with and without CKD (eGFR <60 vs. ≥60 ml/kg/1.73 m2).
Methods
We identified patients with diabetes who initiated SGLT2i (n=925), GLP1RA (n=810), dipeptidyl peptidase-4 inhibitors (DPP4i, n=1899), or sulfonylurea (SU, n=3285) between 2015 and 2018 in Geisinger Health System. Outcomes were percent weight change per year among all patients within 1 year after medication initiation and time to first achieving 5% weight loss among patients with overweight/obesity at medication initiation. Inverse probability of treatment weighting (IPTW) based on multinomial propensity scores was used to account for differences in baseline patient characteristics by medication class.
Results
The mean (SD) age of the 6919 patients was 58 (14) years and 3381 (49%) were female. Compared with SU, SGLT2i, GLP1RA, and DPP4i were associated with significant weight loss, with stronger associations for SGLT2i and GLP1RA (Table). Similarly, SGLT2i, GLP1RA, and DPP4i users were more likely to achieve 5% weight loss compared with SU (HR [95% CI]: 1.47 [1.28, 1.69] for SGLT2; HR: 1.55 [1.32,1.82] for GLP1; HR: 1.31 [1.19,1.44] for DPP4i). The associations were consistent across CKD status.
Conclusion
In patients with and without CKD, SGLT2i and GLP1RA were associated with significant weight loss compared with SU. These results may further motivate uptake of SGLT2i and GLP1RA, two classes of medications with proven renal benefit, among patients with overweight or obesity.
Percent weight change (%/year) within 1 year associated with diabetes medications
| Before IPTW | After IPTW | |
| Sulfonylureas (n=3281) | 0 (Ref) | 0 (Ref) |
| SGLT2 (n=925) | -3.17 (-3.76, -2.57) | -3.02 (-3.63, -2.13) |
| GLP1 (n=810) | -2.94 (-3.56, -2.32) | -2.87 (-3.51, -2.22) |
| DPP4 (n=1899) | -1.69 (-2.14, -1.25) | -1.71 (-2.15, -1.27) |
Funding
- NIDDK Support