Journal of Obesity & Weight Loss Therapy
Open Access

Abstract

There has been a flurry of anti-diabetic medications since 2005 and the list is ever-expanding. These newer therapies include,
glucagon-like peptide-1 (GLP-1) analogues, dipeptidyl peptidase-4 (DDP-4) inhibitors and sodium glucose co-transporter 2
(SGLT-2) inhibitors. Prior to their introduction, diabetes management was plagued by the invariable notorious side-effect of weight
gain with the use of sulfonyl ureas (~2-3 kg), thiazolidinediones (~2–3 kg) and in particular with insulin (~4-10 kg). The latter
group of medications remain a massive deterrent to both healthcare professionals in terms of prescribing and patients in respects to
adherence as weight gain is undesirable and results in poor body image, depression, hypertension, hyperlipidaemia and an increased
rate of micro- and macro-vascular diabetic complications. The newer therapies, apart from their anti-diabetic properties offer the
desired effect of weight reduction (~2-3 kg) or at least weight neutrality (DDP-4 inhibitors). More recently, a GLP-1 analogue has
been approved for management of obesity with promising efficacy (mean weight reduction of ~4-5 kg) in both non-diabetic and
diabetic subjects. These newer therapies add to the armamentarium of therapies in addressing the global pandemic of diabetes and or
obesity. Some of these offer other health benefits including a reduction in systolic and diastolic blood pressure (~4/2 mm of Hg) and
improvement in some markers of hyperlipidaemia. The mechanisms through which weight loss is targeted, the data from the trials
and the use of these newer agents in medically managing the ever-increasing tide of diabetes and obesity will be examined.

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