Use of Antidiabetic Agents for Treating Obesity
Antidiabetic agents refer to all the different types of medicine involved in the treatment of diabetes. All these agents aim to reduce blood sugar levels to an acceptable range (called achieving normoglycemia) and relieve symptoms of diabetes such as thirst, excessive urination, and ketoacidosis (a serious complication of diabetes that occurs when the body cannot use glucose as a fuel source). Antidiabetic agents also prevent the development of, or slow the progression of, long-term complications of the disease, such as nephropathy (kidney disease), neuropathy (nerve damage), and retinopathy (damage to the retina of the eye).
Common antidiabetic
agents include:
· - Alpha-glucosidase
inhibitors (acarbose, miglitol)
· -Amylin
analogs (pramlintide, cagrilintide)
· - Dipeptidyl
peptidase 4 inhibitors (alogliptan, linagliptan, saxagliptin, sitagliptin)
· -Incretin
mimetics or GLP-1 agonist (semaglutide, albiglutide, dulaglutide, exenatide,
liraglutide, lixisenatide)
· - Insulin
· - Meglitinides
(nateglinide, repaglinide)
· -Non-sulfonylureas
(metformin)
· -SGLT-2
inhibitors (canagliflozin, dapagliflozin, empagliflozin)
· - Sulfonylureas
(chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, tolbutamide)
· -Thiazolidinediones (rosiglitazone, pioglitazone)
Some are available in combination.
Type I diabetes is a
condition where the body does not produce any insulin. Therefore, insulin is
the only treatment effective for type 1 diabetes. Injected insulin acts just
like naturally occurring insulin to lower blood glucose levels.
People with type 2 diabetes initially have insulin resistance - this is when the cells of the body do not respond to insulin in the same way as people without diabetes. Oral antidiabetic agents work in various ways to reduce blood sugar levels in people with type 2 diabetes; some stimulate insulin secretion by the pancreas, others improve the responsiveness of cells to insulin or prevent glucose production by the liver. Others slow the absorption of glucose after meals. Many people with type 2 diabetes eventually require insulin to manage their high blood sugar levels.
Weight-loss
benefits of combining the GLP-1 receptor agonist Semaglutide with the
long-acting amylin analogue Cagrilintide:
·
Semaglutide is an antidiabetic medication used for the
treatment of type 2 diabetes and an anti-obesity medication used for long-term
weight management. It is a peptide similar to the hormone glucagon-like
peptide-1 (GLP-1), modified with a side chain. It
can be administered by subcutaneous injection or taken orally.
Cagrilintide is a long-acting analogue of amylin. Amylin, or islet amyloid polypeptide (IAPP), is a peptide hormone. It is co-secreted with insulin from the pancreatic β-cells in the ratio of approximately 100:1 (insulin: amylin). Amylin plays a role in glycemic regulation by slowing gastric emptying and promoting satiety, thereby preventing post-prandial spikes in blood glucose levels.
According to a phase 1b
randomized controlled trial, adding an investigational long-acting amylin analogue
cagrilintide to semaglutide was both safe and effective for weight management.
Out of six different
doses of once-weekly subcutaneous cagrilintide tested, certain doses plus 2.4
mg of the GLP-1 receptor agonist semaglutide resulted in significantly greater
weight loss compared with semaglutide alone, reported Lone B. Enebo, PhD, of
Novo Nordisk in Søborg, Denmark, and colleagues.
Semaglutide has been
approved as a weight loss medication for individuals who are overweight or
obese but do not have type 2 diabetes.
In a study, treatment
with cagrilintide for 26 weeks in participants with overweight or obesity
without type 2 diabetes showed significant reductions in bodyweight and was
well tolerated.
SGLT2 inhibitors are a
class of prescription medicines that are approved for use with diet and
exercise to lower blood sugar in adults with type 2 diabetes. Medicines in the
SGLT2 inhibitor class include canagliflozin, dapagliflozin, and empagliflozin. SGLT2
inhibitors directly cause body weight loss via glucose excretion (calorie loss)
in the kidneys, therefore, SGLT2 inhibitors may prove to be an effective weight
loss therapy in patients with obesity without diabetes.
Disclaimer: The above article is for information purpose only. Both Semaglutide, Cagrilintide and SGLT-2 Inhibitors are prescription medicines, that can only be made available to a patient on the written instruction of an authorised health professional. Do not try to self-medicate yourselves with these.
1.
https://www.sciencedirect.com/science/article/abs/pii/S0140673621017517
3.
https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=131155
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