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Sibutramine and Hypocaloric Diet Improve Metabolic Profile in Type II Diabetics: Presented at EASD

By Emma Hitt
Special to DG News

BUDAPEST, HUNGARY -- September 3, 2002 -- Sibutramine (Meridia) administered with a hypocaloric diet aids weight loss and improves parameters of metabolic control in obese patients with type 2 diabetes and obese individuals with impaired glucose tolerance, a new study suggests.

Sibutramine, a serotonin and noradrenalin re-uptake inhibitor, may reduce weight and improve glycemic control in obese patients with type 2 diabetes.

"Generally weight loss, as it improves insulin sensitivity, decreases the demand on the insulin secretory system," note Dr. Oya Ersoy, with the Department of Endocrinology and Diabetes, Sisli Etfal Education and Research Hospital, Istanbul, Turkey and colleagues. "The net effect is generally to decrease insulin secretion, thereby reducing the stress on the pancreas and improving metabolic control."

Dr. Ersoy and colleagues presented the results of their study at the European Association for the Study of Diabetes (EASD) meeting, in Budapest, Hungary, here.

In their study, they compared the effects of 10 mg once daily sibutramine treatment in 32 obese (mean body mass index [BMI] 32) patients with type 2 diabetes, 30 obese (mean BMI 33.2) non-diabetic patients, and 41 obese (mean BMI 33.1) patients with impaired glucose tolerance (IGT).

All patients also ate a low-calorie diet, maintaining a caloric deficit of between 250 to 500 calories per day for six months.

Systolic and diastolic pressures, glucose, HbA1c, insulin and serum lipid levels, insulin resistance and insulin sensitivity were measured at baseline and after 6 months of treatment.

Compared to BMI at baseline, BMI at six months was significantly reduced in all three groups (p<0.001). HbA1c was significantly reduced in diabetic patients (p<0.001) and in patients with IGT (p<0.01). Furthermore, sibutramine decreased 30, 60 and 120 minute glucose levels significantly (p<0.05 for each time) in patients with IGT but not in non-diabetics.

Significant improvement in measurements of insulin sensitivity and insulin resistance were seen in diabetic patients (p<0.05 for both measures) and patients with IGT (p<0.01 for both measures). But sibutramine had no effect on these measures in non-diabetic patients despite lowering BMI.

Systolic and diastolic pressures or serum lipid levels did not appear to change in any of the three groups.

According to the researchers, weight loss improves both peripheral insulin sensitivity and the ability of insulin to suppress hepatic glucose uptake into muscle and adipose tissue, and these effects may explain the benefits of sibutramine in these patients.

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