Dr. Ahmed Xultophy is a combination of Liraglutide and Degludec, available in a single pen-filled injection. Degludec is a long-acting Insulin while Liraglutide is a GLP-1 analog.
Weight gain is a common side effect of insulin, especially in a person who is on multiple daily injections.
Xultophy (Degludec + Liraglutide) is a great option for people who are gaining weight with multiple doses of insulin + basal insulin (the basal-bolus regimen).
Because Liraglutide is a GLP-1 analog, it is a potent antidiabetic drug. It is available as a single drug (without Degludec) by the names, VIctoza and Saxenda.
Victoza is a low-dose formulation approved for diabetes while Saxenda is approved for weight loss.
Icosema is another combination of once-weekly Insulin Icodec and Semaglutide that is yet to be approved.
Is Xultophy associated with weight loss or weight gain?
Xultophy is a weight-neutral medicine. It contains insulin degludec and Liraglutide. The weight-gaining effect of insulin degludec is minimized by Liraglutide.
Liraglutide causes satiety and fullness. Like Semaglutide (Ozempic), it is associated with significant weight loss. For weight loss, it is approved as Saxenda injections for obese individuals with diabetes and even those who do not have diabetes.
Weight Loss with Xultophy Vs Glargine:
This is a brief history of one of our patients who is getting treatment for diabetes, hypertension, depression, and diabetic nephropathy.
He was on Insulin Actrapid (regular human insulin) 16 units in the morning, 8 units at lunchtime, and 12 units before dinner, along with 44 units of insulin glargine.
He was also taking Galvusmet (Vildagliptin and metformin) in a dose of 50/1000 twice daily, along with Fluoxetine, Telmisartan, Aspirin, statin, and pantoprazole.
His sugars were controlled but he complained of weight gain, especially around the belly and flanks.
At the time of his medical examination, his body weight was 89 kg (196 lbs).
He was switched from Glargine 44 units to Xultophy 40 units along with metformin 1000 mg twice daily and Inj. Actrapid.
The rest of his medications were continued as such.
After a follow-up of 6 weeks, his sugars were controlled and he lost 3 kg (6.6 lb) of his baseline body weight.
However, he had severe GI upset, nausea, and abdominal pain. He could not tolerate Xultophy anymore.
He was advised to eat small frequent meals but he insisted on switching back to his old regimen.
Weight loss with Xultophy vs Glargine – at the cost of side effects!
Although Xultophy helped our patient lose weight, the side effects were not easily tolerated. In fact, he requested to switch back to his old insulin regimen.
It is important to understand that weight loss is always associated with either one or more of the following:
- You don’t feel like eating:
- Symptoms may include: Anorexia, fullness, early satiety, and feeling of nausea
- You don’t absorb your meals:
- Symptoms may include: abdominal gases, diarrhea (sometimes constipation), abdominal pain, sticky stools, and vitamin deficiency
- Your metabolic rate increases:
- Symptoms may include palpitations, sweating, insomnia, and irritability.
Here are some tips if you want to lose weight without developing side effects:
If you are planning to lose weight, you must start slowly. Try aerobic exercises, HIIT, or any other form of activity first.
In addition, switch to a low-calorie diet, intermittent fasting, or at least reduce your portion size.
Once you think, your weight is stuck or these things are not helping you, then you can consult your doctor, who may advise you on a weight loss medicine or stop any medicine you are taking that is causing weight gain.
It is also important to get yourself tested for thyroid hormone, cortisol, growth hormone, and any other medical cause that may be the cause of your weight gain.
How has your experience been with Xultophy?
- Question of
Have you used Xultophy for managing diabetes?
- Yes
- No
- Question of
Have you used Glargine (Lantus) for managing diabetes?
- Yes
- No
- Question of
Which medication do you think is the most effective for controlling diabetes?
- Xultophy
- Glargine
- Question of
What is your biggest concern regarding Glargine (Lantus)?
- Side effects
- Cost
- Effectiveness
- Question of
Did you lose or gain weight while using Glargine (Lantus)?
- Lost weight
- Gained weight
- No significant change
- Question of
Did you lose or gain weight while using Xultophy?
- Lost weight
- Gained weight
- No significant change
- Question of
In your experience, which medication is better for weight loss?
- Xultophy
- Glargine
- Neither
