Soliqua: Weight Loss or Weight Gain

Soliqua is a fixed drug combination of GLP-1 analog, Lixisenatide, and Insulin Glargine (Lantus, Toujeo, Basaglar). GLP-1 analogs are associated with weight loss while Insulin use is associated with weight gain.

Combining Lixisenatide with Insulin Glargine may minimize the weight gain associated with Insulin Glargine if given alone or with other diabetes drugs.

In addition to reducing the number of injections, Sloiqua (Lixisenatide/Glargine) may better control diabetes by lowering A1C compared to each drug given alone.

What is Soliqua?

Soliqua is a medication approved for the treatment of type 2 diabetes in adults. It is used in conjunction with diet and exercise to improve and control blood sugar levels.

It starts working within 90 minutes after it is administered into the skin and releases slowly into the bloodstream for 24 hours.

Soliqua is the combination of two important diabetes drugs in a fixed dose:

• Insulin glargine, 100 units/mL, and
• Lixisenatide, 33 mcg/mL,

Hence Soliqua is usually written as Soliqua 100/33. It is available as a pen injector and administered once daily without regard to meals.

Soliqua Weight Loss Effects:

Since Soliqua contains Insulin glargine, it is likely to cause some weight gain. however, the weight-gaining effect of Insulin Glargine is minimized by Lixisenatide, a short-acting GLP-1 analog.

Hence, gaining weight is not a typical side effect of Soliqua (insulin glargine and Lixisenatide).

In fact, patients using Soliqua lost between 0.1 and 0.3 kg on average in several clinical trials. Although this is minuscule, but since most diabetes drugs cause weight gain, it is still significant for a person on insulin and not gaining weight.

The weight loss seemed significant when it was compared to the weight gain in patients who just used insulin glargine. With Insulin glargine, the weight gain ranged from 1.1 to 2 kg (2.6 and 4.4 lb).

It is important to note that most newer GLP-1 analogs are associated with significant weight loss and two of them (Wegovy, Saxenda) have been approved by the FDA primarily for the treatment of obesity.

Soliqua Weight loss in Trials:

Soliqua 100/33 compared to insulin glargine may help in minimizing the chances of weight gain that can occur with Insulin Glargine.

In one 30-week study known as the LixiLan-O study, insulin glargine/lixisenatide—the two ingredients in Soliqua—was contrasted with each ingredient—insulin glargine (Lantus) and Lixisenatide (Adlyxin)—given separately [ref].

• Patients with type 2 diabetes who were not well controlled by oral type 2 diabetes medications, such as metformin, participated in this trial.
• Patients on insulin glargine/Lixisenatide (Soliqua) lost 0.3 kg (0.6 lbs) of weight while those taking simply insulin glargine gained 1.1 kg.
• A 2.3 kg weight loss was experienced by those who used Lixisenatide exclusively.

The LixiLan-O study’s subgroup analysis focused on patients with high A1C levels of at least 9% [ref].

• A1C is a gauge of blood sugar stability over a period of time.
• When compared to those using simply insulin glargine, those receiving insulin glargine/Lixisenatide at the beginning of the research gained less weight (1.3 kg or 2.9 lbs Vs 2 kg or 4.4 lbs).
• Those who were solely taking Lixisenatide lost 1.5 kg of weight (3.3 lbs).

The LixiLan-O study’s subgroup analysis included participants whose type 2 diabetes was uncontrolled despite receiving two oral medications [ref].

• The results demonstrated a statistically significant difference between those receiving insulin glargine alone and those receiving it in combination with Lixisenatide (the active ingredient in Soliqua).
• Soliqua led to a weight loss of 0.1 kg (0.2 lbs) while Insulin Glargine resulted in a weight gain of 1.3 kg (2.9 lbs).
• Those who were solely taking Lixisenatide lost 2.3 kg of weight (5 lbs).

In the LixiLan-L research, patients with type 2 diabetes who weren’t controlled on basal insulin and oral glucose-lowering medications were compared to insulin glargine/Lixisenatide (the active ingredients in Soliqua) [ref].

• At 30 weeks, a favorable effect on body weight was seen.
• In patients receiving insulin glargine and Lixisenatide, the average body weight was reduced by 0.7 kg (1.5 lbs), but it increased by 0.7 kg (1.5 lbs) in those receiving insulin glargine alone. It was determined that this difference was statistically significant.

What potential negative effects could Soliqua 100/33 have?

Common side effects

Nausea, diarrhea, upper respiratory infections, stuffy or runny noses, and headaches are some of the most frequent adverse effects of Soliqua 100/33.

When you initially begin using Soliqua 100/33, nausea and diarrhea are more common.

Low blood sugar levels (hypoglycemia)

Low blood sugar levels (hypoglycemia). If you take another medication that can cause low blood sugar, your chances of getting it are increased.

Low blood sugar symptoms include headache, dizziness, drowsiness, sweating, lack of strength, mood swings, hunger, blurred vision, fast heartbeat, jitteriness, confusion, and anxiety.

Difficulties with digestion

With Soliqua 100/33, digestive issues are probable. These include diarrhea and nausea, both of which were frequent throughout the drug’s clinical trials.

Other digestive issues with Soliqua 100/33 may occur less frequently.

These consist of:

• Constipation,
• Vomiting,
• Indigestion,
• Abdominal pain,
• Flatulence (gas),
• Bloating, and
• Anorexia (reduced appetite)

If you experience diarrhea or vomiting while using Soliqua 100/33, it’s critical to stay hydrated. You can stay hydrated by consuming liquids such as Pedialyte or Gatorade.