Weight loss medications and diabetes

Some weight loss medications can be an effective component of a diabetes management plan.

Key takeaways

• Given the association between overweight and obesity, weight loss medications can play a role in the treatment of type 2 diabetes.
• While weight loss medications can’t cure diabetes, they may be able to help reduce the need for or the amount of other treatments, such as insulin injections.
• Your healthcare practitioner can determine if medications that help with both weight management and diabetes treatment,  are appropriate for the management of your diabetes.

Overview

Diabetes is primarily classified into two main types:

• Type 1 diabetes: Previously known as juvenile diabetes, type 1 diabetes often starts in childhood or adolescence, although it can occur in adults too. It’s an autoimmune condition in which the body’s immune system mistakenly attacks and destroys insulin-producing cells in the pancreas.
• Type 2 diabetes: More often developing in adults or teens, type 2 diabetes is a condition in which the body’s cells have become resistant to insulin, coupled with a relative lack of insulin production over time.

A third type, gestational diabetes, occurs during pregnancy and usually resolves after delivery, but it can increase the risk of developing type 2 diabetes later in life.

Symptoms, causes and risk factors

Causes and risk factors of diabetes

While the exact causes of diabetes are complex and vary depending on the individual and the type of diabetes, the most well-known factors include:

• Genetic predisposition: Genetic factors, family history, and various ethnicities increase the risk of developing both type 1 and type 2 diabetes.
• Autoimmune reaction: In type 1 diabetes, the immune system mistakenly destroys insulin-producing cells in the pancreas.
• Riskfactors: In type 2 diabetes, diet (especially those high in starches and sugars), decreased physical activity, overweight and obesity, increase the risk of developing the condition.
• Hormonal changes during pregnancy: In gestational diabetes, hormonal changes make the body less responsive to insulin.

Side effects of diabetes

• Frequent urination
• Blurred vision
• Increased thirst and dry mouth
• Unexplained weight changes
• Persistent hunger, even after eating
• Unusual fatigue or lack of energy
• Slow healing of wounds
• Frequent infections or skin disorders
• Numbness or tingling in hands and feet

Diagnosis and tests

Diabetes is diagnosed using a variety of tests that may be taken over different days to confirm the diagnosis. The primary methods of diagnosing diabetes are: 

• Fasting plasma glucose test: This measures blood glucose levels after an eight-hour fast.
• Random plasma glucose test: A blood sample is taken at a random time, regardless of when the last meal was consumed.
• Oral glucose tolerance test: This test involves fasting overnight and then drinking a sugary liquid. If blood sugar levels are over a certain threshold over the two hours after the drink, it may indicate diabetes.
• A1C test: This blood test reflects the average blood sugar level for the past two to three months. 

Management and treatment

Diabetes management aims to keep blood glucose levels as close to normal as possible and to prevent or manage complications associated with the disease.

Treatment approaches can vary depending on the type of diabetes and might include:

• Risk factor modifications: Often the first step in managing type 2 diabetes, this includes regular physical activity, a balanced diet, weight management, and smoking cessation.
• Blood glucose monitoring: Regular self-testing of blood glucose levels helps gauge the success of treatment. This can be done using finger prick tests or by wearing a continuous glucose monitor.
• Medications: Several oral and injectable medications, including prescription medications that are also used for weight loss, exist to help manage blood glucose levels.
• Insulin therapy: People with type 1 diabetes require life-long insulin therapy, which involves injecting insulin several times a day or using an insulin pump. Some people with type 2 diabetes may also need insulin therapy if other treatments are not sufficient.
• Management of associated cardiovascular risk factors: This includes controlling blood pressure and cholesterol levels, both through lifestyle changes and often with medication.

Prevention

Type 1 diabetes cannot currently be prevented due to its genetic nature, but there are several evidence-based strategies to reduce the risk of developing type 2 diabetes, including:

• Dietary choices: Consuming a diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats.
• Physical activity: Engaging in regular physical activity.
• Maintaining a healthy weight: Related to the first two strategies, maintaining a healthy weight can help reduce the risk of developing type 2 diabetes. Overweight and obesity are significant risk factors for type 2 diabetes.
• Managing blood pressure and cholesterol levels: Regular monitoring and treatment, if needed.

Outlook/prognosis

With effective management, complications of type 1 and type 2 diabetes can be reduced. This includes monitoring and managing glucose levels, engaging in physical activity regularly, and eating a healthy sustainable diet. 

Early detection can also improve outcomes by delaying or preventing complications.

If not properly managed, the long-term complications of diabetes can be serious, affecting the eyes, nerves, heart, kidneys, and other organs/body systems.

Frequently asked questions

What are weight loss medications?

Weight loss medications are drugs prescribed by a licensed healthcare practitioner that can be used to improve the control of blood sugar and support weight loss in people with overweight or obesity, including people with diabetes.

Can weight loss medications cure diabetes?

Weight loss medications cannot cure diabetes, but they can be an effective treatment for people with diabetes by helping patients with their blood glucose control and often also with weight management. 

Sometimes patients with diabetes are able to decrease or eliminate other diabetic medications when they are taking weight loss medications.

Can weight loss medications and insulin be taken at the same time?

Weight loss medications and insulin can sometimes be taken at the same time, but this varies according to the patient. It’s common for insulin dosage to be reduced and sometimes discontinued upon starting a weight management medication under the direction of a healthcare practitioner.

There is an increased risk of hypoglycemia — low blood sugar — when using weight loss medications in conjunction with insulin. Make sure to discuss with your pharmacist if you’re taking insulin and starting a weight loss medication. Patients should closely monitor glucose levels using a continuous glucose monitor when taking these medications, especially when first starting or increasing their dose.

Do you have to stay on weight loss medications for diabetes for life?

When taking any medication for diabetes, the decision by your healthcare practitioner to stop, change doses, or remain on treatment is generally based on blood glucose control over time. It’s possible for people with type 2 diabetes to achieve blood glucose control through non-pharmacologic treatments and reduce or stop their medications, including weight management medications, if the reason for starting the medications is only for blood glucose management. 

However, obesity is considered a chronic condition, so if someone is taking weight loss medications to treat obesity as well as diabetes, they may require long-term treatment to manage their body size. Users may also stop for other reasons, like side effects, loss of insurance coverage, or prohibitive costs. It’s crucial not to stop or change any treatment without a discussion with your healthcare practitioner.

Does taking weight loss medication for diabetes lead to weight loss?

While weight loss medication may be prescribed primarily for diabetes symptoms in some cases, it’s not uncommon for those patients to experience weight loss as well.

Weight loss can also be dose-dependent. When indicated for diabetes, the maximum dose of common weight loss medications is 2 mg, while the maximum dose for weight loss indications is 2.4 mg. Some patients taking the maximum dose for diabetes may experience weight loss, while others may require a higher dose.

Who should take weight loss medications for diabetes?

There are many medications and non-pharmacological treatments available for diabetes. Only a licensed healthcare practitioner with knowledge of your medical history can determine if you should take weight loss medications over other treatments in order to treat diabetes. They make their decisions based on medical conditions, disease progression, severity of insulin resistance, and other factors. 

Since there is an association between overweight/obesity and diabetes, it is possible for weight loss medications to play a role in treating patients with diabetes. Your practitioner can help you find the best treatment for your condition. 

Want to read more about weight loss medications like semaglutide and other treatments? Visit the Felix Blog for more resources. If you think prescription weight loss treatment might be right for you, start an online visit with Felix to see if you qualify.

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Note: When we refer to weight loss medications, we specifically mean a class of drugs called GLP-1 receptor agonists. These are drugs that mimic a naturally occurring hormone called glucagon-like peptide 1. They work by regulating hunger signals in the brain and slowing down the rate at which the stomach empties after a meal, increasing the feeling of fullness.