New Study Finds Patients With Diabetes and Obesity Benefit from Weight Loss When Taking GLP-1R Agonists for Glucose Control

In a new study published in the journal Obesity, researchers from UPMC and University of Pittsburgh Department of Medicine Divisions of General Internal Medicine and Endocrinology and Metabolism evaluated the real-world effects of glucagon-like peptide-1 agonists (GLP-1R agonists) on weight loss among patients with type 2 diabetes and are overweight or obese.

Gretchen E. White, PhD, assistant professor of Medicine in the Division of General Internal Medicine, was the study's first author.

Joining Dr. White on the study from the Division of Endocrinology and Metabolism at UPMC were David A. Rometo, MD, clinical associate professor of Medicine and clinical lead of the Endocrine Obesity Unit and Weight Management Program, and Mary Korytkowski, MD, emeritus professor of Medicine and prior director of Quality Improvement in the Division.

Also collaborating on the study were Ingrid Shu from the University of Pittsburgh Center for Pharmaceutical Policy and Prescribing, Jon Arnold, MD, and senior study author, Jing Luo, MD, MPH, assistant professor, both from the Division of General Internal Medicine.

Study Design and Key Findings

The study analyzed medical record data from a cohort of 2,405 people with type 2 diabetes who were newly prescribed a GLP-1R agonist for management of elevated blood glucose levels between 2011 and 2018. At the study's outset, the patient cohort had a mean body mass index of 37 kg/m² and a mean baseline body weight of 108 kg (238 pounds).

The primary objectives of this investigation were to determine the percent of body weight change in these individuals and to ascertain the number of individuals who achieved a clinically significant reduction in weight defined as ³ 5% at 72 weeks after first being prescribed any GLP-1R agonist.

“The key aspect of this study is that we examined real-world patient data,” explains Dr. White. “We have seen previously in tightly controlled clinical trials that GLP-1R agonists can lead to significant weight reduction. What our study asks and answers is what kind of effect on weight these drugs can have when prescribed to individuals for the intended purpose of blood glucose management in patients taking them in recommended doses as part of their routine clinical care for type 2 diabetes.”

The team's analysis found that the mean weight among all study participants decreased by 1.1% during the first eight weeks following initiation of the GLP-1R agonist to 2.2% at the study's 72-week endpoint.

A third of the cohort was found to have achieved a ³ 5% weight reduction at 72 weeks.

“Our study has encouraging findings about these agents and what we are seeing in a real-world clinical setting regarding weight loss in patients with obesity and diabetes,” says Dr. White. “In addition to improved diabetes management, there is the potential for a downstream benefit in weight loss for many patients, which also is associated with health benefits itself. This is encouraging information for both clinicians and patients.”

More Questions to Answer

Dr. White and colleagues see their study as the first foray into this area of investigation and have several questions that will be explored in the future.

"Ideally, we would like to examine the difference between patients who have high medication adherence and those who don't. Additionally, it would be beneficial to identify certain patient characteristics that may predict better weight loss for those taking these medications," says Dr. White. "This information would have significant clinical implications. "

Learn more about the Division of Endocrinology and Metabolism at UPMC.

More About Dr. White

Gretchen E. White, PhD, MPH, is an assistant professor of Medicine in the Division of General Internal Medicine at the University of Pittsburgh School of Medicine. Dr. White’s research is diverse and spans the topics of bariatric surgery outcomes, obesity, alcohol use, and substance use. She has an overarching interest in epidemiological methods, particularly those related to the design, conduct, and analysis of observational studies, clinical trials, and complex surveys.

Learn more.

Study Reference

White GE, Shu I, Rometo D, Arnold J, Korytkowski M, Luo J. Real-world Weight-loss Effectiveness of Glucagon-like Peptide-1 Agonists Among Patients With Type 2 Diabetes: A Retrospective Cohort Study. Obesity. 2023; 31: 537-544.