|
 |
|
|||||||
|
|||||||||
© 2003 by the American Diabetes Association, Inc.
Emerging Treatments and Technologies |
A Randomized Trial of Sibutramine in the Management of Obese Type 2 Diabetic Patients Treated With Metformin
1 Diabetes and Endocrinology Research Group, Department of Medicine, University Hospital Aintree, Liverpool, U.K
2 Division of Endocrinology, Dalhousie University, Halifax, Canada
OBJECTIVE—To evaluate the effects of sibutramine (15 and 20 mg/day) on weight, metabolic control, and blood pressure in metformin-treated obese subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—A 12-month randomized prospective placebo-controlled double-blind study was performed. It included 21 primary and secondary care centers in England, Canada, France, and Belgium. A total of 195 subjects (44% male) with type 2 diabetes and a BMI >27 kg/m2 were studied. Changes were assessed in weight, blood pressure and resting heart rate, HbA1c, fasting glucose, and lipids.
RESULTS—Sibutramine induced significant weight loss (P < 0.001) with both 15 mg/day (5.5 ± 0.6 kg at 12 months) and 20 mg/day (8.0 ± 0.9 kg), whereas placebo did not (0.2 ± 0.5 kg). Weight loss 
10% was achieved by 14 and 27% of subjects receiving 15 and 20 mg, respectively, but by none given placebo. Glycemic control improved in parallel with weight loss, and subjects who lost 10% weight showed significant decreases in both HbA1c (1.2 ± 0.4%, P < 0.0001) and fasting plasma glucose (1.8 mmol/l, P < 0.001). HDL cholesterol increased slightly with the higher dose, whereas plasma triglycerides fell with both doses, especially in subjects with weight loss of 10% (a 29% decrease, P < 0.01). Treatment was generally well tolerated. Sibutramine treatment raised sitting diastolic blood pressure by 5 mmHg in a higher proportion of patients than did placebo (43% with 15 mg/day vs. 25% with placebo, P < 0.05), but this effect was less evident in subjects who had a weight loss of 10% weight. Pulse rate increased significantly more with sibutramine, being 10 bpm higher in 42% of treated patients versus 17% with placebo (P < 0.01).
CONCLUSIONS—Sibutramine can be an effective adjunct to metformin treatment in selected obese type 2 diabetic subjects and improves metabolic control in individuals who lose weight.
Abbreviations: UKPDS, U.K. Prospective Diabetes Study
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  Z. T. Bloomgarden American College of Endocrinology Pre-Diabetes Consensus Conference: Part Two Diabetes Care, November 1, 2008; 31(11): 2222 - 2229. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Wilding and N. Finer Weight management and cardiovascular disease: implications of recent and ongoing clinical trials The British Journal of Diabetes & Vascular Disease, July 1, 2008; 8(4): 170 - 176. [Abstract] [PDF]
|
|
|
|
 |
|
 K. C. Dunican, A. R. Desilets, and R. J. DeBellis State of the Art Review: Long-term Pharmacotherapy for Overweight and Obesity: A Review of Sibutramine, Orlistat, and Rimonabant American Journal of Lifestyle Medicine, October 1, 2007; 1(5): 367 - 388. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Hollander Anti-Diabetes and Anti-Obesity Medications: Effects on Weight in People With Diabetes Diabetes Spectr, July 1, 2007; 20(3): 159 - 165. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Bray and F. L. Greenway Pharmacological Treatment of the Overweight Patient Pharmacol. Rev., June 1, 2007; 59(2): 151 - 184. [Full Text] [PDF]
|
|
|
|
 |
|
 D. C.W. Lau, J. D. Douketis, K. M. Morrison, I. M. Hramiak, A. M. Sharma, E. Ur, and for members of the Obesity Canada Clinical Practic 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary] Can. Med. Assoc. J., April 10, 2007; 176(8): S1 - S13. [Full Text] [PDF]
|
|
|
|
|
|
D. C.W. Lau, J. D. Douketis, K. M. Morrison, I. M. Hramiak, A. M. Sharma, E. Ur, and pour les membres du Groupe d'experts d'Obesite Can Lignes directrices canadiennes de 2006 sur la prise en charge et la prevention de l'obesite chez les adultes et les enfants [sommaire] Can. Med. Assoc. J., April 10, 2007; 176(8): SF1 - SF14. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Carver Insulin Treatment and the Problem of Weight Gain in Type 2 Diabetes The Diabetes Educator, November 1, 2006; 32(6): 910 - 917. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Gadde and D. B. Allison Cannabinoid-1 Receptor Antagonist, Rimonabant, for Management of Obesity and Related Risks Circulation, August 29, 2006; 114(9): 974 - 984. [Full Text] [PDF]
|
|
|
|
 |
|
 D. T Villareal, C. M Apovian, R. F Kushner, and S. Klein Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society Am. J. Clinical Nutrition, November 1, 2005; 82(5): 923 - 934. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Finer Does pharmacologically induced weight loss improve cardiovascular outcome? Impact of anti-obesity agents on cardiovascular risk factors Eur. Heart J. Suppl., November 1, 2005; 7(suppl_L): L32 - L38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. P. T. James The SCOUT study: risk-benefit profile of sibutramine in overweight high-risk cardiovascular patients Eur. Heart J. Suppl., November 1, 2005; 7(suppl_L): L44 - L48. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Redmon, K. P. Reck, S. K. Raatz, J. E. Swanson, C. A. Kwong, H. Ji, W. Thomas, and J. P. Bantle Two-Year Outcome of a Combination of Weight Loss Therapies for Type 2 Diabetes Diabetes Care, June 1, 2005; 28(6): 1311 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Li, M. Maglione, W. Tu, W. Mojica, D. Arterburn, L. R. Shugarman, L. Hilton, M. Suttorp, V. Solomon, P. G. Shekelle, et al. Meta-Analysis: Pharmacologic Treatment of Obesity Ann Intern Med, April 5, 2005; 142(7): 532 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Vettor, R. Serra, R. Fabris, C. Pagano, and G. Federspil Effect of Sibutramine on Weight Management and Metabolic Control in Type 2 Diabetes: A meta-analysis of clinical studies Diabetes Care, April 1, 2005; 28(4): 942 - 949. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Wilding Obesity treatment: the key to managing the type 2 diabetes timebomb? The British Journal of Diabetes & Vascular Disease, July 1, 2004; 4(4): 217 - 219. [PDF]
|
|
|
|
 |
|
 D. E. Arterburn, P. K. Crane, and D. L. Veenstra The Efficacy and Safety of Sibutramine for Weight Loss: A Systematic Review Arch Intern Med, May 10, 2004; 164(9): 994 - 1003. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. McTigue, R. Harris, B. Hemphill, L. Lux, S. Sutton, A. J. Bunton, and K. N. Lohr Screening and Interventions for Obesity in Adults: Summary of the Evidence for the U.S. Preventive Services Task Force Ann Intern Med, December 2, 2003; 139(11): 933 - 949. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |