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Some Type 2 Diabetes Drugs Linked to Weight Gain

type 2 diabetes drugs and weight gain

Overweight and obesity are generally associated with type 2 diabetes, so it seems sensible you would not want to treat the disease with drugs that can cause weight gain. Although an increase in body fat has been observed for some time with use of certain type 2 diabetes drugs, a research team believes they now know why.


Among the different classes of drugs used to treat type 2 diabetes are thiazolidinediones (TZDs). Drugs in this class include Actos (pioglitazone), Actoplus Met (pioglitazone and metformin), Duetact (pioglitazone and glimepiride), Avandia (rosiglitazone), Avandamet (rosiglitazone and metformin), and Avandaryl (rosiglitazone and glimepiride). Rosiglitazone and its combinations are available only through certified pharmacies because of serious side effects.

Thiazolidinediones work by reducing the amount of glucose (sugar) produced by the liver and lowering insulin resistance in fat and muscle. According to the findings of a new study, published in The Journal of Neuroscience, these drugs also activate sensors on cells in the brain that are responsible for appetite, resulting in an increase in hunger and thus body fat and weight.

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More specifically, peroxisome proliferator-activated receptor gamma sensors are bound to agouti-related protein cells, which are the cells targeted by thiazolidinediones. Scientists at Georgia State University discovered that when they activated the sensors in rodent models, the animals became hungry immediately, ate more food, and stored more for later.

However, when the researchers blocked the sensors, the animals ate less and stored less food, even if they had been deprived of food for a while. According to Johnny Garretson, one of the study’s authors and a doctoral student in the Neuroscience Institute and Center for Obesity Reversal at Georgia State, “People taking these TZDs are hungrier, and they do gain more weight. This may be a reason why.”

What this study means
Experts have known for some time that thiazolidinediones are associated with weight gain, but now a feasible explanation has been provided. It seems like a good time for patients with type 2 diabetes who are taking these medications and who are struggling with weight gain, overweight, or obesity to talk to their doctors about alternative ways to manage their disease and their weight problem.

Garretson JT et al. Peroxisome proliferator-activated receptor gamma controls ingestive behavior, agouti-related protein, and neuropeptide Y mRNA in the arcuate hypothalamus. The Journal of Neuroscience 2015; 35(11): 4571