Weight gain associated with antidiabetic medications

Diabetes has emerged as the major epidemic of modern times, with obesity, particularly central obesity, being a major risk factor for Type 2 diabetes and its attendant cardiovascular disease. Furthermore, weight reduction has been shown to prevent Type 2 diabetes in people with prediabetes and to improve glycemic control and reduce cardiovascular disease risk in the diabetic population. Weight gain is a major problem that faces physicians striving to achieve adequate glycemic, blood pressure and lipid control for their diabetic patients. The use of antidiabetic agents, particularly insulin, insulin secretagogs and thiazolidinediones, has long been associated with weight gain, not only complicating the management of diabetes but also sending mixed messages to patients who are being asked to lose weight. This article presents the effects of antidiabetic medications on bodyweight, explaining the potential mechanisms of weight gain and also discusses the available therapeutic options that could achieve better glycemic control without adverse effects on bodyweight or, even better, cause weight loss.