Efficacy of Pharmacotherapy for Weight Loss in Adults With Type 2 Diabetes Mellitus: a Meta-Analysis
Posted on: Thursday, 18 November 2004, 03:00 CST
Norris SL, Zhang X, Avenell A, Gregg E, Schmid CH, Kim C, Lau J: Efficacy of pharmacotherapy for weight loss in adults with type 2 diabetes mellitus: a meta-analysis. Arch intern Med 164:1395-1404, 2004
Findings. This study was a meta-analysis of 14 randomized placebo- controlled trials with fluoxetine, orlistat, and sibutramine for weight toss, with a total of 2,231 patients. Pharmacotherapy produced modest reductions in weight for fluoxetine (3.4 kg [95% CI 1.7-5.2] at 8-16 weeks of follow-up, 5.1 kg [3.3-6.9] at 24-30 weeks, and 5.8 kg [0.8-10.8] at 52 weeks), orlistat (2.6 kg [2.1- 3.2] [2.6% loss] at 52 weeks), and sibutramine (4.5 kg [1.8-7.21 [3.3% loss] at up to 26 weeks). Glycated hemoglobin was also modestly reduced by these treatments: fluoxetine (1.0% [0.4-1.5] at 8-16 weeks, 1.0% [0.6-1.4] at 24-30 weeks, and 1.8% -0.2-3.8] at 52 weeks), orlistat (0.4% [0.3-0.5]), and sibutramine (0.7% [-0.5- 1.9]). Gastrointestinal adverse effects were common with orlistat; tremor, somnolence, and sweating with fluoxetine; and palpitations with sibutramine.
Significance. Obesity is closely related to type 2 diabetes, and weight reduction is an important part of the care advised to obese persons with diabetes, but success with weight loss through lifestyle change is usually not successful in practice. This study demonstrates that in patients with type 2 diaebtes and obesity, fluoxetine, orlistat, and sibutramine can achieve modest but statistically significant weight loss over 26-52 weeks. However, the magnitude of weight loss was modest, and the long-term health benefits and safety remain unclear. Nevertheless, the weight loss is associated with improvement in diabetes control.
Impact. Weight loss drugs are effective in improving diabetes control in obese patients despite only modest effects on body weight.
Copyright American Diabetes Association Nov 2004
Source: Diabetes Care
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