TABLE 1.

Common anti-diabetic medications that play a role in the regulation of thermogenic adipose tissue.

Categories of anti-diabetic medications	Anti-diabetic mechanism	Drugs that act on thermogenic adipose tissue	Thermogenic adipose tissue effects and potential mechanisms	References
Sulfonylureas	Stimulates insulin secretion; reduces insulin clearance and glucagon secretion; improves insulin sensitivity	Glibenclamide	Improves sympathetic innervation of BAT; activation of β3 AR-PKA signaling	Kuo et al. (2020)
PPARγ activators	Improve insulin sensitivity	Lobeglitazone, rosiglitazone, pioglitazone, and WO95E	Induce beiging; activate the SIRT1–PRDM16 pathway	Ohno et al. (2012); Qiang et al. (2012)
Metformin	Activates AMPK; enhances the uptake and usage of glucose	Metformin	Increases BAT mass and expression of thermogenic markers in BAT; improves mitochondria biogenesis, lipolysis, and fatty acid uptake in BAT; activates intestinal α1AMPK and builds an intestine–BAT communication; promotes brown adipogenesis and thermogenesis through αlAMPK–PRDM16 signaling; induces beiging	Yang et al. (2016); Karise et al. (2019); Abbasi et al. (2022); Zhang et al. (2022a)
SGLT2 inhibitors	Inhibit glucose reabsorption through renal tubules	Canagliflozin, ipragliflozin, and empagliflozin	Induce beiging; enhance mitochondrial biogenesis and respiratory activity; promote lipolysis and fatty acid oxidation in adipose tissue; activate AMPK- sirtuin 1- PGC-1α signaling; elevate the sympathetic innervation of adipose tissue; facilitate fat mobilization via β3AR–cAMP–PKA signaling	Lee et al. (2021); Xu et al. (2021); Yang et al. (2021)
GLP-1 analogs	Suppress appetite and delay gastric emptying; facilitate insulin secretion from pancreatic β-cells	Liraglutide and exendin-4	Induce BAT and beige adipose tissue thermogenesis; activate AMPK in the hypothalamic ventromedial nucleus; improve sympathetic innervation of thermogenic adipose tissues	Lockie et al. (2012); Beiroa et al. (2014); Kooijman et al. (2015)