Evidence map›Paper›PMID 39853913›Full record

ArticleJournal of diabetes2025

Is Weight Loss the Main Driver for A1C Improvement by Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists? A 2.5-Year Analysis in Real-World Clinical Practice.

Marwa Al-Badri, Shilton Dhaver, Osama Hamdy

Abstract read
In one paragraph

Article in Journal of diabetes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Marwa Al-BadriJoslin Diabetes Center, Affiliated With Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-4998-9708
Shilton DhaverJoslin Diabetes Center, Affiliated With Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-5281-6728
Osama HamdyJoslin Diabetes Center, Affiliated With Harvard Medical School, Boston, Massachusetts, USA.

Funding

SPECIAL ASSAY COREP30DK036836 · NIDDK · JOSLIN DIABETES CENTER · PI JEAN E. SCHAFFER · 1986 to 2026
$50.5M
NIDDK NIH HHS P30 DK036836
6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are established treatment options for type 2 diabetes (T2D). In addition to their glycemic benefit, GLP-1 RAs also induce weight loss by suppressing appetite via hypothalamic pathways. However, it remains unclear whether weight reduction is the primary driver of glycemic improvement.

methodsWe retrospectively evaluated 256 patients with T2D who were treated with exenatide (n = 84), dulaglutide (n = 99), or semaglutide (n = 73) for 2.5 years without interruption in real-world clinical practice. Body weight and A1C were measured every 6 months. Baseline characteristics included an average age of 61.8 ± 11.9 years, 51.5% female, diabetes duration of 12.9 ± 8.3 years, weight of 103.1 ± 20.7 kg, BMI of 35.7 ± 7.5 kg/m

resultsThe first tertile experienced an average weight loss of -12.2% ± 5.7% (p < 0.0001), the second tertile lost -3.5% ± 1.4% (p < 0.0001), and the third tertile gained +2.8% ± 3.4% (p < 0.0001). The average changes in A1C were - 0.98 ± 1.8% (p < 0.0001), -0.56% ± 1.4% (p < 0.001), and -0.19% ± 1.9% (p = 0.4), respectively. A1C strongly correlated with weight change (p < 0.001). The same observations were reproducible in each medication group.

conclusionsThese findings suggest that the long-term improvement in glycemic control associated with GLP-1 RA therapy is primarily driven by weight loss rather than any other intrinsic effect of GLP-1 RA. This highlights the importance of weight reduction as a key therapeutic target for optimizing glycemic outcomes in patients with T2D receiving GLP-1 RAs.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsGlycated HemoglobinHypoglycemic AgentsWeight LossAgedBlood GlucoseExenatideFemaleGlucagon-Like Peptide 1Glucagon-Like PeptidesHumansImmunoglobulin Fc FragmentsMaleMiddle AgedRecombinant Fusion ProteinsBlood GlucosedulaglutideExenatideGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsGlucagon-Like PeptidesGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsImmunoglobulin Fc FragmentsRecombinant Fusion ProteinsSemaglutideGLP‐1 receptor agonistsglycemic controlreal‐world clinical practicetype 2 diabetesweight loss

Identifiers

PMID39853913
PMCPMC11757277

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.