Next-Generation Diabetes Medications Helping Patients Lose Weight Could Be the Key to Heart and Kidney Health

Recently, there's been a lot of chatter on social media about some new diabetes medications that are also helping people lose weight. There has been some cutting-edge research on the link between cardiovascular, kidney, and metabolic health - also known as cardiometabolic health – and these new medications are the result of that research.

But how do these medications work? Are they safe to use for weight loss purposes? Let’s explore one type of medication - sodium-glucose cotransporter-2 inhibitors, or SGLT2 inhibitors for short. Approved SGLT2 inhibitor medications include Jardiance®, Brenzavvy™, Farxiga®, Invokana®, and Steglatro®.

A Single Medicine For a Range of Health Conditions

You might be surprised to learn how much potential these medications have beyond weight loss. In 2013, the first SGLT2 inhibitor was approved by the FDA to help control blood glucose levels in adults with type 2 diabetes. Since then, more clinical research has been done and SGLT2 inhibitors are now approved for:

• Lowering blood pressure for people with type 2 diabetes.
• Decreasing the risk of heart attack and stroke in people with type 2 diabetes and established cardiovascular disease.¹
• Reducing hospitalizations and deaths from heart failure in people with and without type 2 diabetes.
• Slowing the progression of kidney disease in people with and without type 2 diabetes.²

How can one medication help with diabetes, cardiovascular disease, kidney disease, and obesity all at the same time?

First, it’s important to understand that these health conditions are all related. Diabetes and high blood pressure damage the kidneys over time. When your kidneys struggle, your heart needs to work harder, and your blood pressure can go even higher. This can create a cycle that, if left uncontrolled, can lead to heart attack, heart failure, kidney failure, and stroke.

What Makes SGLT2 Inhibitors Different

SGLT2 inhibitors are medications that focus on blocking sugar in your body from getting into your body's cells. By stopping your kidneys from absorbing glucose, these medications force this excess glucose to leave through your urine. This not only helps manage blood glucose but also protects your kidneys and heart and reduces the amount of calories your body intakes.

SGLT2 inhibitors are only approved for specific health situations and must be prescribed by a doctor. While there's potential to use them more widely in the future, more research is needed to ensure they’re safe and effective for broader use. Clinical trials are essential to finding out if this new type of medication can protect more people from cardiovascular disease, kidney disease, and diabetes.

What We Know About SGLT2 Inhibitors for Weight Loss

Currently, the FDA has not approved SGLT2 inhibitors solely for weight loss. Although many patients who take SGLT2 inhibitors for type 2 diabetes do lose weight, they typically only lose a few pounds. Few research studies have looked at SGLT2 inhibitors for weight loss in obese people without diabetes. In those studies, the people who took SGLT2 inhibitors only lost a few pounds.³

More clinical trials are needed to determine if SGLT2 inhibitors alone or in combination with other medications can effectively help people with obesity lose weight. This research is crucial to ensuring that these medications are truly effective and don’t cause harmful side effects.

CONTRIBUTING EXPERTS

Sinikka Green, MD

Dr. Green is the Medical Director and a Principal Investigator at Care Access. She is board certified in emergency medicine.

SOURCES

1. Mancia G, Cannon CP, Tikkanen I, et al. Impact of Empagliflozin on Blood Pressure in Patients With Type 2 Diabetes Mellitus and Hypertension by Background Antihypertensive Medication. Hypertension. 2016;68(6):1355-1364. doi:10.1161/HYPERTENSIONAHA.116.07703
2. Padda IS, Mahtani AU, Parmar M. Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors. [Updated 2023 Jun 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576405/
3. Pereira MJ, Eriksson JW. Emerging Role of SGLT-2 Inhibitors for the Treatment of Obesity. Drugs. 2019;79(3):219-230. doi:10.1007/s40265-019-1057-0