Longitudinal impact of sodium-glucose co-transporter-2 versus dipeptidyl peptidase-4 inhibitors on weight and body mass index in type 2 diabetes: a 12-month comparative analysis

Syed Raziuddin Fiasal; Shekar H. S.; Syed Afzal Uddin Biyabani; Hafsa Naema

doi:10.18203/2320-6012.ijrms20253955

Authors

Syed Raziuddin Fiasal Department of Pharmacy Practice, Visveswarapura Institute of Pharmaceutical Sciences, Bengaluru, Karnataka, India
Shekar H. S. Department of Pharmacy Practice, Visveswarapura Institute of Pharmaceutical Sciences, Bengaluru, Karnataka, India
Syed Afzal Uddin Biyabani Department of Pharmacy Practice, Rajiv Gandhi University of Health Sciences Bangalore Karnataka, India
Hafsa Naema Department of Pharmacy Practice, Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253955

Keywords:

SGLT-2 inhibitors, DPP-4 inhibitors, Type 2 diabetes mellitus, Weight reduction

Abstract

Background: Obesity and elevated body mass index (BMI) are strongly associated with poor glycaemic control and increased cardiometabolic risk in type 2 diabetes mellitus (T2DM). Beyond glycaemic efficacy, contemporary antidiabetic agents are increasingly evaluated for their effects on weight and metabolic outcomes. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors are widely prescribed, yet comparative long-term data on their impact on weight and BMI in Indian populations remain limited.

Methods: This 12-month observational study included 200 T2DM patients 100 each receiving SGLT-2 or DPP-4 inhibitors. Assessments were conducted at baseline and at 3, 6, 9, and 12 months. Primary outcomes were changes in body weight and BMI, analysed using SPSS v31.0 with paired t-tests, repeated measures ANOVA, and Bonferroni/Sidak post hoc tests. Statistical significance was set at p<0.05.

Results: Patients on SGLT-2 inhibitors exhibited consistent and significant reductions in both parameters: mean body weight declined from 91.61±4.09 kg to 77.63±4.61 kg (Δ=-13.98 kg, p<0.001), and BMI from 29.57±2.68 to 23.13±2.09 (Δ=-6.44, p<0.001). Conversely, DPP-4 users showed negligible changes (Δ=+0.14 kg and -0.10, both p>0.3). The SGLT-2 group’s weight loss was progressive and sustained throughout 12 months. Although gender distribution was similar (p=0.744), younger age in the SGLT-2 group may have influenced outcomes.

Conclusions: SGLT-2 inhibitors produced significant, durable reductions in weight and BMI versus DPP-4 inhibitors, highlighting their dual metabolic advantage in comprehensive T2DM management.

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