MeRIT Project: Prevalence of medications that affect weight gain in the obese population with type 2 diabetes

Introduction: Uncontrolled diabetes can lead to multiple complications. Obesity is associated with chronic diseases and presents challenges to diabetes control. Certain medications used to treat diabetes and other comorbidities can increase weight. Evaluating current prescribing practices can help identify ways to optimize treatment to minimize medication-induced weight gain and/or promote weight loss that can lead to improvement in HbA1c.

Objectives: To examine whether there is an association between obesity and weight-gain inducing medications in adults diagnosed with type 2 diabetes.

Study Design: This study will be conducted as a case-control study where the cases include obese patients (BMI ≥ 30 kg/m2) and the control patients include non-obese patients (BMI <30 kg/m2) with diabetes. This study is IRB-exempt.

Methods: Adult patients were included if they have type 2 diabetes and a visit in the internal medicine clinic within the past year. The following was collected from de-identified data extracted from the electronic medical record: age, gender, race, insurance, medical diagnoses and their linked medications, vitals, and labs. Medications used to treat diabetes and comorbidities that are considered to weight-inducing by the 2015 Endocrine Society guideline on Pharmacological Management of Obesity were identified. The association between obesity and the use of medications that induce weight gain will be determined using the chi square test.

Results: Review of 25 obese patients with diabetes showed that 68% of patients are on medications that cause weight gain. Insulin, sulfonylureas, beta blockers, and gabapentin are the most commonly prescribed weight-inducing medications while the recommended weight-neutral or weight-losing diabetes medications such as metformin, DPP-4 inhibitors, and GLP-1 agonists are under-prescribed.

Conclusions: Majority of obese patients with diabetes are on medications that cause weight gain. However, additional review and comparison with non-obese patients is needed to determine if there is an association.