Diabetes Medication and Weight Gain

As we continue to study various diabetes medications and patient experiences, I am struck by the number of oral medications that cause weight gain. Patients reported weight gain with 12 of the 18 drugs we studied. And 6 drugs had weight gain incidences of 12.9% (Amaryl) to 31.5% (Actoplus Met). This means that of all of the reports of side effects, weight gain reports comprised 31.5% for Actoplus Met, for example.

Many type 2 patients are trying to lose weight. So the fact that their medication makes that close to impossible and actually has them gaining what could be significant amounts of weight is unacceptable to them.

However, many physicians seem to dismiss patient complaints of weight gain. And today I read an article that sparked this post. I was reviewing information about Takeda releasing new data this week to the FDA on their DPP IV inhibitor, alogliptin. Alogliptin and Actos+alogliptin were originally rejected by FDA because Takeda did not have enough cardiovascular safety data. Takeda is running more studies to specifically look at cardio issues, which is a good thing.

In my research, I found an article from 2010 where researchers favorable to the Actos+alogliptin combo stated that the greater the increase in weight a patient experienced, the greater the decrease in HbA1c. He therefore concluded that the weight gain was purely cosmetic and not a metabolic issue. This was a peer-reviewed article on the NIH website published in Vascular Health Risk Management. In our study, Actos had an incidence of weight gain of 22.5% with some patients report as gaining as much as 50-60 pounds in a manner of a few months.

Significant weight gain has to further stress the already stressed system of a patient with diabetes. More weight has to be a bigger problem that simply cosmetic.

So not only are patients faced with physicians who do not disclose the weigh gain potential of their medications but those evaluating new drugs may not take this side effect seriously. There are several studies that show that even a 5-10% reduction in weight, say 10 to 20 pounds in someone who weight 200, reduces blood glucose levels and reduces the need for medications.

Patients find weight gain caused by diabetes medication to be important and want physicians and researchers to feel the same way.