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| |  ADA: Orlistat (Xenical) Benefits Overweight Diabetics Receiving Insulin Therapy By Jill Stein Special to DG News PHILADELPHIA, PA -- June 24, 2001-- Orlistat (Xenical) plus diet is a useful adjunctive treatment for improving glycemic control and several cardiovascular disease (CVD) risk factors in obese patients with type 2 diabetes who are suboptimally controlled with insulin and other anti-diabetic therapies. Investigators reported these findings at the 61st Scientific Sessions of the American Diabetes Association (ADA) in Philadelphia, Pennsylvania. While weight loss improves glycemic control, lipid profile, and blood pressure in type 2 diabetics, this improvement is difficult to achieve and sustain long-term, particularly in patients receiving insulin therapy, which in itself promotes weight loss. Against this background, Dr. George A. Bray and associates at the Pennington Biomedical Research Group in Baton Rouge, Louisiana, studied the effect of orlistat on body weight, glycemic control, and CVD risk factors in 535 obese diabetic patients who were clinically stable but suboptimally controlled on insulin alone or combined with oral agents. Overweight and obese diabetic patients with a body mass index of 28 to 43 kg/m2[/<sup>] and hemoglobin A1c (HbA1c) of 7.5 to 12.0 percent were randomized to treatment with a reduced calorie diet (600 kcal per day deficit) plus orlistat (120 mg tid) or placebo.
Changes in body weight, glycemic control, blood pressure, and lipid levels over one year were compared in the two groups.
After one year, orlistat-treated patients lost significantly more weight than placebo-treated patients, and this difference was evident by the fourth week and lasted throughout the trial. In addition, more orlistat than placebo patients achieved a weight loss of at least 5 percent of their baseline weight or at least 10 percent.
Orlistat was also associated with significantly greater decreases compared to placebo in HbA1c, fasting plasma glucose, and required doses of insulin and other anti-diabetic medications.
The improvements over one year were significantly greater for orlistat than placebo patients with respect to total cholesterol, low- density lipoprotein cholesterol, the low-density lipoprotein/high-density lipoprotein ratio, and waist circumference.
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