Pre-diabetes, a metabolic condition characterized by elevated blood glucose levels that do not meet the threshold for diabetes, affects a significant portion of the global population and is a major risk factor for the development of type 2 diabetes and cardiovascular diseases (1). The prevalence of pre-diabetes is estimated at 29%-73% in the elder population, and 9% of those with pre-diabetes progress to diabetes (2). The prevalence of pre-diabetes is growing globally (3). Managing pre-diabetes is pivotal in preventing its progression, and weight management is a cornerstone in this preventive strategy (4).

Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), initially approved for the treatment of type 2 diabetes (5), has shown promise in weight reduction among diabetic patients (6). Its mechanism of action includes the delay of gastric emptying and the enhancement of satiety, potentially leading to reduced calorie intake and subsequent weight loss (7). Given its success in diabetic populations, there is a growing interest in exploring the efficacy of liraglutide in individuals with pre-diabetes and other diseases (8, 9), particularly as a means of managing weight and potentially forestalling the onset of type 2 diabetes.

Despite the growing body of research, there is variability in the reported outcomes concerning the effectiveness of liraglutide in weight management among individuals with pre-diabetes. Furthermore, the translation of weight loss into a reduction in the progression of pre-diabetes to diabetes has not been consistently quantified (10). The rationale for focusing on individuals with pre-diabetes is underscored by the reversible nature of this condition through lifestyle interventions and pharmacotherapy (11). In addition, weight loss has been significantly correlated with a decreased risk of developing type 2 diabetes (12), making it imperative to identify effective weight management strategies for at-risk populations.

The variability and lack of a cohesive synthesis of available data necessitates a systematic review and meta-analysis to critically evaluate the extent of liraglutide’s impact on weight management in individuals with pre-diabetes and to assess the heterogeneity among the extant studies. This systematic review and meta-analysis aim to consolidate current evidence from randomized controlled trials (RCTs) on the effectiveness of liraglutide in managing weight among individuals with pre-diabetes.