A retrospective case-control study to assess the correlation of weight loss and GLP-1 analogs in patients with TYPE 2 diabetes

M Aamir Mirza, Naseha Batul, Mustaq Ahmad, Mohammad Daud Ali, Nuzhat Banu, Mohammed Aslam

Abstract


Background: Obesity, defined as a BMI of 30 kg/m² or above, has become a key driver of type 2 diabetes mellitus (T2DM), a condition linked to considerable morbidity, mortality, and healthcare resource utilization. While pharmacological management of T2DM continues to evolve, glucagon-like peptide-1 (GLP-1) analogs have gained attention for their dual metabolic benefit of glycaemic control and weight reduction. This study examined the extent to which GLP-1 analog therapy influences weight outcomes among adults with T2DM.

Methods: A retrospective cohort design was used to evaluate obese adults with T2DM treated at Max Super Specialty Hospital, Saket, New Delhi, between July 2017 and February 2018. Patients were stratified into GLP-1 analog cohort and non-GLP-1 cohort, and changes in weight and HbA1c from baseline to 6 months were analyzed using paired t-tests within groups and independent samples t-tests between groups.

Results: Diagnostic and treatment records were available for 376 patients, evenly split into a GLP-1 analog cohort (n=188) and a comparator cohort (n=188), with a mean participant age of 58.4 years. Across the entire study population, Hba1c declined modestly by approximately 0.3 percentage points (7.9 ± 0.8% to 7.6 ± 0.7%). in the GLP-1 analog cohort, Hba1c reduction was substantially greater, averaging about 1.3 percentage points, indicating a stronger glycemic response among exposed patients.

Conclusion: The magnitude of metabolic improvement with GLP-1 analog therapy appeared proportional to baseline disease severity, with patients presenting higher initial BMI, glucose, and HbA1c values showing the greatest gains. As HDL and LDL changes were not statistically significant, this conclusion should be limited to glycaemic profile (HbA1c) and BMI as predictors.

Keywords

GLP-1 analogs, Type 2 diabetes mellitus, Body mass index, HbA1c, Weight reduction


Full Text:

PDF

References


WHO. Obesity and overweight. Geneva, [https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight](https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight). Last accessed on 15 October 2025.

Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee. IDF DIABETES ATLAS [Internet]. 10th edition. Brussels: International Diabetes Federation; 2021. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK581934/](https://www.ncbi.nlm.nih.gov/books/NBK581934/). Last accessed on 10 October 2025.

Gassasse Z, Smith D, Finer S, Gallo V. Association between urbanisation and type 2 diabetes: an ecological study. BMJ Global Health, (2017); 2(4): e000473.

Hamdy O, Ashrafzadeh S, Mottalib A. Weight management in patients with type 2 diabetes: a multidisciplinary real-world approach. Current Diabetes Reports, (2018); 18(9): 66.

Apovian CM, Okemah J, O’Neil PM. Body weight considerations in the management of type 2 diabetes. Advances in Therapy, (2019); 36(1): 44-58.

Tella SH, Rendell MS. Glucagon-like polypeptide agonists in type 2 diabetes mellitus: efficacy and tolerability, a balance. Therapeutic Advances in Endocrinology and Metabolism, (2015); 6(3): 109-134.

Diamant M, Van Gaal L, Guerci B, Stranks S, Han J, Malloy J, et al. Exenatide once weekly versus insulin glargine for type 2 diabetes (DURATION-3): 3-year results of an open-label randomised trial. Lancet Diabetes & Endocrinology, (2014); 2(6): 464-473.

Wysham C, Grimm M, Chen S. Once weekly exenatide: efficacy, tolerability and place in therapy. Diabetes, Obesity and Metabolism, (2013); 15(10): 871-881.

Bergenstal RM, Wysham C, Macconell L, Malloy J, Walsh B, Yan P, et al. Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomised trial. Lancet, (2010); 376(9739): 431-439.

Buse JB, Rosenstock J, Sesti G, Schmidt WE, Montanya E, Brett JH, et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet, (2009); 374(9683): 39-47.

Hall GC, McMahon AD, Dain MP, Wang E, Home PD. Primary-care observational database study of the efficacy of GLP-1 receptor agonists and insulin in the UK. Diabetic Medicine, (2013); 30(6): 681-686.

Di Loreto C, Minarelli V, Nasini G, Norgiolini R, Del Sindaco P. Effectiveness in real world of once weekly semaglutide in people with type 2 diabetes: glucagon-like peptide receptor agonist naïve or switchers from other glucagon-like peptide receptor agonists: results from a retrospective observational study in Umbria. Diabetes Therapy, (2022); 13(3): 551-567.

Castellana M, Cignarelli A, Brescia F, Laviola L, Giorgino F. GLP-1 receptor agonist added to insulin versus basal-plus or basal-bolus insulin therapy in type 2 diabetes: a systematic review and meta-analysis. Diabetes/Metabolism Research and Reviews, (2019); 35(1): e3082.

Drab SR. Glucagon-like peptide-1 receptor agonists for type 2 diabetes: a clinical update of safety and efficacy. Current Diabetes Reviews, (2016); 12(4): 403-413.

Watanabe JH, Kwon J, Nan B, Reikes A. Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022. Journal of the American Pharmacists Association, (2024); 64(1): 133-138.

Hansen KB, Svendstrup M, Lund A, Knop FK, Vilsbøll T, Vestergaard H. Once-weekly subcutaneous semaglutide treatment for persons with type 2 diabetes: real-world data from a diabetes out-patient clinic. Diabetic Medicine, (2021); 38(10): e14655.

Gulati K, Wijndaele K, Webb J, von Arx LB, Seif M, Jennison T, et al. Achievement of HbA1c and weight targets in adults with type 2 diabetes on once weekly injectable glucagon-like peptide-1 receptor agonist therapy in UK primary care: a retrospective, real-world study. Diabetes Obesity and Metabolism, (2025); 27(4): 2086-2095.

Williams DM, Ruslan AM, Khan R, Vijayasingam D, Iqbal F, Shaikh A, et al. Real-world clinical experience of semaglutide in secondary care diabetes: a retrospective observational study. Diabetes Therapy, (2021); 12(3): 801-811.

Nolen-Doerr E, Stockman MC, Rizo I. Mechanism of glucagon-like peptide 1 improvements in type 2 diabetes mellitus and obesity. Current Obesity Reports, (2019); 8(3): 284-291.




DOI: https://doi.org/10.62940/als.v13i3.3665

Refbacks

  • There are currently no refbacks.