Role of sibutramine in the treatment of obese Type 2 diabetic patients receiving sulphonylurea therapy

• Published in: Diabetic medicine Vol. 19; no. 2; pp. 119 - 124
• Main Authors: Serrano-Rios, M., Melchionda, N., Moreno-Carretero, E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.02.2002
• Subjects: Appetite Depressants - adverse effects; Appetite Depressants - therapeutic use; Body Mass Index; Body Weight - drug effects; Cholesterol - blood; Cyclobutanes - adverse effects; Cyclobutanes - therapeutic use; Diabetes Mellitus - drug therapy; Diabetes Mellitus, Type 2 - drug therapy; Female; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Male; Middle Aged; Obesity; Placebos; sibutramine; SNRI; Sulfonylurea Compounds - adverse effects; Sulfonylurea Compounds - therapeutic use; Triglycerides - blood; Type 2 diabetes; Weight Loss - drug effects
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1046/j.1464-5491.2002.00655.x

Aims To investigate whether the satiety‐inducing agent sibutramine affected body weight and associated anthropometry in overweight and obese (body mass index (BMI) > 27) Type 2 diabetic patients on sulphonylurea therapy. Methods A randomized, placebo‐controlled trial was undertaken in 134 patients with stable metabolic control on chronic sulphonylurea therapy. Patients were placed on moderate caloric restriction and received treatment with either sibutramine (15 mg/day) or placebo for 6 months. Results Fifty‐three of 69 sibutramine‐treated and 57/65 placebo‐treated patients completed the study. Both groups showed progressive weight loss. At the end of the trial weight loss was two times greater in the sibutramine group (mean ± sem; −4.5 ± 0.5 kg) than placebo (−1.7 ± 0.5 kg, P < 0.001 vs. sibutramine). There was a trend for more patients to lose > 5% of initial body weight in the sibutramine group than placebo. BMI (P < 0.001) and waist circumference (P < 0.001) were also decreased to a greater extent by sibutramine. Mean reductions in HbA1c were commensurate with weight loss in both the sibutramine and placebo (−0.78 ± 0.17% and −0.73 ± 0.23%; P = 0.84). Sibutramine was well tolerated with only two patients withdrawn due to potentially drug‐related serious adverse events (palpitations). Conclusions Sibutramine, in conjunction with moderate caloric restriction, enhances weight loss and reduces waist circumference in overweight and obese Type 2 diabetic patients receiving sulphonylurea therapy. This is associated with additional improvements in glycaemic control in a limited number of patients losing ≥ 10% of their baseline body weight.