Teneligliptin is for T2D, not weight loss

Teneligliptin is for T2D, not weight loss

The name isn't easy to read (or say), but the results stand out – Teneligliptin is a drug used for type 2 diabetes that does not seem to correlate well to weight loss in general, unlike GLP1 agonists.

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In a recently published study, Teneligliptin provided some benefits to production of GLP1, and weight loss in participants, BUT it is still best used for type 2 diabetes.

Even with the published study, there are reasons to be cautious:

  • The study size was small (75 people in test group, 75 people in control)
  • The formulation is relatively new and untested
  • Diet and exercise were added as part of the trial

That said, seeing more drugs beneficial to weight loss is great to see, hopefully increasing options for everyone.

What is Teneligliptin?

A brief overview can be found on Wikipedia:

Teneligliptin - Wikipedia

Teneligliptin is a type 2 diabetes drug that works slightly differently from GLP1 receptor agonists – in particular it blocks an enzyme called dipeptidyl peptidase-4 (DDP4), which normally reduce blood glucose.

DDP4 blockers increase the amount of GLP1 and GIP in the body, but don't seem to have quite the same effects as synthetic GLP1/GIP likely because of the speed with which GLP1s and GIP are cleared from the body.

Is it approved for use?

Teneligliptin is used in Japan and Korea, but has not passed the bar for approval by the FDA in the United States.

In 2015, the FDA also put out a warning that DDP4-inhibitors can cause severe joint pain:

FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain | FDA
[8-28-2015] The U.S. Food and Drug Administration (FDA) is warning that the type 2 diabetes medicines sitagliptin, saxagliptin, linagliptin, and alogliptin may cause joint pain that can be severe and disabling.

So while the FDA did not do anything drastic like revoke it's approval, it did feel

Does it work?

The research is some what mixed on whether DDP4 blockers work – a particular meta analysis found that they did not have significant benefits for heart disease, all-cause mortality, or other benefits:

Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis
How do sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors compare in reducing mortality and cardiovascular events in patients with type 2 diabetes?In this network…

That said, with the central focus being on type 2 diabetes and weight loss, there may still be hope.

Of course, there is still the study quoted in this article, which did see surface some benefits from using Teneligliptin in particular – but that's not enough to overturn the other evidence that seems to the contrary.

Teneligliptin looks to work primarily on reducing blood glucose and less on weight loss, as other GLP1 RAs have been found to coincidentally achieve.

Teneligliptin: a DPP-4 inhibitor for the treatment of type 2 diabetes
Dipeptidyl peptidase-4 (DPP-4) inhibitors have recently emerged as a new class of antidiabetic that show favorable results in improving glycemic control with a minimal risk of hypoglycemia and weight gain. Teneligliptin, a novel DPP-4 inhibitor, exhibits…
Efficacy and Safety of Teneligliptin in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Background: Teneligliptin is a 3rd-generation dipeptidyl peptidase-4 (DPP-4) inhibitor. There is a limited evidence regarding the effect of teneligliptin. Therefore, this study is to assess the efficacy and safety of teneligliptin in type 2 diabetes mellitus…

The lack of use and data related to Teneligliptin in Europe and the US points to the fact that there are better options for weight loss and type 2 diabetes management on the market today – we think those options are GLP1 receptor agonists, for the most part.