5
Concomitant Pharmacotherapy
Diabetes Mellitus Medications
May increase body weight:
• Most insulins
• Sulfonylureas
• Thiazolidinediones ("-zones")
• Meglitinides (e.g., nateglinide,
repaglinide)
May decrease body weight:
• Metformin
• Glucagon-like peptide-1 receptor agonists (e.g., "-tides")
• GLP-1 RA/glucose-dependent insulinotropic peptide (GIP)
• Sodium glucose co-transporter 2 inhibitors (e.g., "-flozins")
• Alpha glucosidase inhibitors (e.g., acarbose, miglitol)
• Amylin mimetic (pramlintide)
Neutral effects on body weight:
• Dipeptidyl peptidase-4 (DPP4) inhibitors (e.g., "-gliptins")
Metformin
• May help improve adiposopathic disorders:
▶ Insulin resistance
▶ Polycystic ovary syndrome
▶ Cardiovascular disease (especially when compared to sulfonylurea)
• May help treat complications of concurrent drug treatments:
▶ Antipsychotic-related weight gain
▶ Human immunodef iciency virus (HIV) protease inhibitor-
associated abnormalities (i.e., HIV lipodystrophy)
• May help reduce the overall cancer rate and help improve the
treatment of multiple cancers:
▶ Colon
▶ Lung
▶ Ovary
▶ Breast
▶ Prostate
• May improve insulin sensitivity and reduce hunger via multifactorial
effects such as enhancing the effects of gastrointestinal hormones
applicable to weight loss (e.g., increased glucagon-like peptide-1
levels and receptors, increased peptide YY, decreased neuropeptide
Y), all of which may facilitate long-term weight loss.
(cont'd)
