Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerPrediabetes
Research Summary
Analyzed using Evidence Intelligence™
Newer diabetes drugs show stronger weight and blood sugar benefits in prediabetes
Last updated May 16, 2026
Key finding
Newer drugs like semaglutide and tirzepatide appear best for weight and blood sugar in prediabetes.
This review compared nine types of diabetes medications in over 16,000 adults with prediabetes across 55 studies. The medications included metformin, newer injectable drugs like semaglutide and tirzepatide, and older pills like pioglitazone. Newer medications like semaglutide and tirzepatide showed the best combined effects for weight loss and blood sugar control. Semaglutide 2.4 mg led to the most weight loss at about 30 pounds. Liraglutide worked best for lowering HbA1c. Older medications like pioglitazone lowered blood sugar effectively but caused weight gain. The newer drugs had more stomach-related side effects but were generally safe.
Quick read
Study at a glance
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
Meta-Analysis
Follow-up
Long-Term (> 12 mo)
Risk of bias
Low Risk
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
Newer drugs like semaglutide and tirzepatide appear best for weight and blood sugar in prediabetes.
Published in
Journal Reference
Publication details and source links for this paper.
Wu Y, Wang Z, Tuersun A, et al. Efficacy and safety of anti-prediabetic drugs in patients with prediabetes: a Bayesian network meta-analysis. BMC Med. 2026;24:174. doi:10.1186/s12916-026-04705-2
Main Effects
Weight → ↓ (strong with semaglutide, tirzepatide)
HbA1c → ↓ (moderate with most drugs)
Cholesterol → ↓ (moderate with tirzepatide, pioglitazone)
Evidence network
How this study fits
Understand where this research contributes within the broader evidence network.
Evidence Context
This study contributes evidence to Dapagliflozin, Liraglutide, Metformin, and 3 more and Body weight, HbA1c, Renal and urinary disorders incidence, and 3 more.
This study contributes evidence to
Primary intervention
Dapagliflozin
Primary outcomes
- Body weight
- HbA1c
- Renal and urinary disorders incidence
Primary intervention
Primary outcomes
Evidence relationships
Intervention and outcome relationships this study adds to the evidence network.
14
Evidence pairs
14
Relationships
9
Evidence topics
contributes_evidence
Editorial context
Why this study matters
See why this paper is useful beyond its individual results.
Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
Limited contributionModerate confidenceNetwork score: 42
9
Related topics
14
Evidence pairs
732
Related studies
High relevance in at least one topic
Why it is useful
- Contributes to 14 evidence relationships
- Linked to 9 direct semantic evidence topics
Topic contributions
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Metformin Therapies and HbA1c
Related evidence
Evidence relationship
GLP-1 Receptor Agonists and Body Weight
Save evidence
Evidence relationship
GLP-1 Receptor Agonists and HbA1c
Save evidence
Core evidence
Study findings
The primary outcomes reported in this study.
Evidence Intelligence™
- EvidenceScore™
- 81
- Strong
- ImpactScore™
- 83
- Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 5 studies
Add to Evidence TrackerRenal and urinary disorders incidence
Dapagliflozin → Renal and urinary disorders incidence
Dapagliflozin → Renal and urinary disorders incidence
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Strong
- Score 79 · Based on 4 studies
- ImpactScore™
- 76
- Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 4 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Moderate
- Score 69 · Based on 2 studies
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 2 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- 85
- Strong
- ImpactScore™
- 80
- Positive
- ConsistencyScore™
- 83
- consistent
Supporting studies: Based on 7 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Strong
- Score 79 · Based on 4 studies
- ImpactScore™
- 75
- Positive
- ConsistencyScore™
- 75
- consistent
Supporting studies: Based on 4 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- 88
- Strong
- ImpactScore™
- 77
- Positive
- ConsistencyScore™
- 90
- consistent
Supporting studies: Based on 11 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- 87
- Strong
- ImpactScore™
- 89
- Very Positive
- ConsistencyScore™
- 85
- consistent
Supporting studies: Based on 13 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Moderate
- Score 69 · Based on 2 studies
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 2 studies
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Library
Build your evidence library
Save research, organize studies, and quickly find important evidence again.
Evidence Suggest
- Newer medications like semaglutide and tirzepatide appear to offer the best combined benefits for weight loss and blood sugar control in people with prediabetes who are overweight
- Older medications like pioglitazone lower blood sugar effectively but cause weight gain, which limits their usefulness
- Effects vary by medication type, with no single drug working best for all outcomes
Who this applies to
Adults aged 18-75 with prediabetes based on blood tests showing HbA1c of 5.7-6.4% or elevated fasting blood sugar
Keep in Mind
Most studies compared drugs to placebo rather than directly to each other, so we can't be certain which drug works best
Between the Lines
- Most studies compared to placebo, not to each other
- Results varied widely between studies
- Study lengths ranged from 3 months to 2+ years
- Most participants were of European ancestry
Connected Evidence
Explore related studies, evidence collections, and research questions.
Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on GLP-1 Receptor Agonists and Body Weight, GLP-1 Receptor Agonists and HbA1c.
Related evidence relationships
Explore in Evidence ExplorerThis study contributes to the evidence on the following intervention-outcome relationships.
Medications
GLP-1 Receptor Agonists → Body Weight
Medications
Evidence Intelligence™
- EvidenceScore™
- 88
- Strong
- ImpactScore™
- 77
- Positive
- ConsistencyScore™
- 90
- consistent
Supporting studies: Based on 11 studies
View evidenceMedications
GLP-1 Receptor Agonists → HbA1c
Medications
Evidence Intelligence™
- EvidenceScore™
- 87
- Strong
- ImpactScore™
- 89
- Very Positive
- ConsistencyScore™
- 85
- consistent
Supporting studies: Based on 13 studies
View evidenceMedications
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 50
- Neutral
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
View evidenceIncluded in these evidence collections
Curated evidence collections and hubs this study is part of.
HbA1c Evidence Hub
All studies measuring HbA1c
13 studies
outcome_hubMeasures HbA1c as a key outcome.
Body Weight Evidence Hub
All studies measuring Body Weight
11 studies
outcome_hubMeasures Body Weight as a key outcome.
GLP-1 Receptor Agonists Evidence Hub
All studies on GLP-1 Receptor Agonists
11 studies
intervention_hubContributes to GLP-1 Receptor Agonists evidence base.
Adipokine and Angiogenic Markers Evidence Hub
All studies measuring Adipokine and Angiogenic Markers
1 studies
outcome_hubMeasures Adipokine and Angiogenic Markers as a key outcome.
Metformin Therapies Evidence Hub
All studies on Metformin Therapies
1 studies
intervention_hubContributes to Metformin Therapies evidence base.
Explore more in Evidence Explorer
Jump to pre-filtered views in Evidence Explorer.
All studies on Semaglutide and Body weight
Intervention: SemaglutideOutcome: Body weight
11 results
All studies on Semaglutide and HbA1c
Intervention: SemaglutideOutcome: HbA1c
13 results
All studies on Semaglutide
Intervention: Semaglutide
11 results
All studies on Metformin
Intervention: Metformin
1 results
All studies measuring Body weight
Outcome: Body weight
11 results
Questions answered by this study
Generated from the study's connected evidence using Evidence Intelligence™.
Does Metformin Therapies improve HbA1c?
Strong Evidence
Metformin Therapies may improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 85.4 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 8 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does GLP-1 Receptor Agonists affect body weight?
Strong Evidence
GLP-1 Receptor Agonists may improve Body Weight.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
Body weight
EvidenceScore™ Strong | EvidenceScore™ 87.5 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 26 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does GLP-1 Receptor Agonists improve HbA1c?
Strong Evidence
GLP-1 Receptor Agonists appears to improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 87.3 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 27 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does SGLT2 Inhibitors improve HbA1c?
Strong Evidence
SGLT2 Inhibitors may improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 80.8 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 9 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Next steps
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Evidence topics
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Dapagliflozin improves metabolic outcomes in type 2 diabetes patientsDapagliflozin may improve RAAS markers in diabetes patientsLiraglutide is well tolerated in diabetes patients undergoing hemodialysis.Liraglutide may reduce stroke recurrence in type 2 diabetes patientsSemaglutide may reduce cardiovascular events in non-diabetic patients.
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