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Endocrine

, Volume 55, Issue 1, pp 173–178 | Cite as

Combination therapy with GLP-1 analogues and SGLT-2 inhibitors in the management of diabesity: the real world experience

  • Herpreet Deol
  • Leoni Lekkakou
  • Ananth K. Viswanath
  • Joseph M. PappachanEmail author
Original Article

Abstract

Diabesity—obesity resulting in diabetes—is a major health problem globally because of the obesity epidemic. Several anti-diabetic medications cause weight gain and may worsen obesity, and possibly diabeisty. Two recent small retrospective cohort studies showed weight loss and diabetes improvement with combination of glucagon-like peptide-1 (GLP-1) agonists and sodium-glucose co-transporter type-2 (SGLT-2) inhibitors in obese subjects. We assessed the effect of combination therapy with GLP-1 agonists and SGLT-2 inhibitors in the management of diabesity in a retrospective study at the Wolverhampton Diabetes Centre. Out of 79 patients on this combination regimen with other anti-diabetic medications, 37 cases who had follow up at 3–6 months were studied. Mean age and duration of follow up were 57.4 (+/−7.8) and 139 (+/−32.6) days, respectively. Twenty-two patients (59.5 %) were Asians. Statistically significant improvements in clinical parameters such as body weight reduction (3.07 kg), glycated haemoglobin (HbA1c) reduction (1.05 %), lower BMI (−1.13 kg/M2) and insulin dose reduction (6.8 units) were observed (p < 0.05 for all) in patients on combination regimen. Linear regression analysis showed that baseline HbA1c and baseline insulin dose were independent predictors of HbA1c reduction and insulin dose reduction, respectively. Our results suggest that combination therapy with GLP-1 agonists and SGLT-2 inhibitors is a promising option for patients with diabesity.

Keywords

Diabesity Glucagon-like peptide-1 (GLP-1) agonist Sodium-glucose co-transporter type-2 (SGLT-2) inhibitors Management of diabesity Anti-diabetic combination regimen 

Notes

Funding

No funding was received for this work

Compliance with ethical standards

Conflict of interest

Ananth K Viswanath received lecture fees from MSD, Novo Nordisk, Takeda, Eilly Lilly, Jansen and sponsorship from Novo Nordisk, Takeda, Novartis and Jansen to attend international conferences. The remaining authors have no conflicts of interest to declare.

Declaration

Both the first and second authors contributed equally to the research and preparation of the manuscript.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Endocrinology & DiabetesNew Cross Hospital, The Royal Wolverhampton Hospitals NHS TrustWolverhamptonUK

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