The
Effects of Orlistat –An Overview of ADA and Endo 2002
Presentations.
Dave
Joffe, R.Ph, FACA
EDITOR
IN CHIEF
The
Effect of Orlistat on Glycemic Control Is Independent of
Weight Loss
JONATHAN
HAUPTMAN, MICHAEL RABBIA. Nutley, NJ
Orlistat
(ORL) in conjunction with a mildly reduced-calorie diet is
associated with improvements in glycemic control, lipid profile
and blood pressure and significant weight loss in patients with
type 2 diabetes (T2D).
The
mean change from baseline in body weight was comparable in ORL-
and PL-treated patients. However, compared to PL-treated patients,
ORL-treated patients had a significantly greater decrease in both
HbA1c
and FPG (LSM differences were -0.43% and -0.85 mmol/L
respectively). A regression analysis demonstrated that the change
in glycemic control in ORL-treated patients was significantly less
correlated to weight loss than for PL-treated patients.
In
conclusion, much of the glycemic improvements in ORL- compared to
PL-treated patients are independent effects not related to weight
loss.
Modelisation
of the 10-year Incidence Reduction of Coronary Events in
Obese Type 2 Diabetes Patients Treated with Orlistat
BERNARD
GUY-GRAND, PAUL VALENSI, JEAN-MICHEL JOUBERT, EVELINE ESCHWEGE,
PHILIPPE AMOUYEL, FRANCIS FAGNANI. Paris, France; Lille, France
Whether
or not the use of antiobesity drugs induces beneficial effects in
terms of morbi-mortality is still an open question due to lack of
long term evidencies. 97 and 96 patients were prescribed Orlistat
120 mg t.i.d or placebo, and a mildly hypolipidic diet; the dosage
of antidiabetic drugs was not modified during the study. These
results suggest that adding Orlistat to the treatment of obese T2D
patients with same level of risk may induce an absolute reduction
of 496 to 686 coronary events for a population of 10,000 obese
diabetics on a 10-year period.
Orlistat
Consistently Improves Glycemic Control in Patients with
Type 2 Diabetes
PRISCILLA
A. HOLLANDER, LUC VAN GAAL. Dallas, TX; Antwerp, Belgium
In
trials involving more than 2500 patients with T2D, orlistat had a
significant, additional effect on HbA1c
levels and FPG after both 24 and 52 weeks of treatment. Therefore,
orlistat, in combination with diet, represents a clinically
beneficial adjunct to anti-diabetic therapy for overweight or
obese patients with T2D.
Effect
of Orlistat on the
Need for Concomitant Anti-Diabetic Medication in Overweight
and Obese Patients with Type 2 Diabetes
JOHN
M. MILES, ALFREDO HALPERN. Kansas City, MO; Sao Paulo, Brazil
A
retrospective analysis of pooled data from 7 multicenter,
double-blind trials was performed to assess the need for
concomitant ADM in overweight or obese patients (body mass index
28-43 kg/m2)
with type 2 diabetes. 50% more patients treated with, orlistat
compared to placebo were able to decrease or discontinue at least
one ADM. More patients using orlistat were able to decrease or
discontinue at least one ADM for each sub-population. orlistat
reduces the usage of ADM in overweight and obese patients with
diabetes, regardless of the ADM used.
Efficacy
of Orlistat in
Patients with Type 2 Diabetes with Baseline HbA1c
Levels >8%
JAIME
A. DAVIDSON, ANTHONY BARNETT. Dallas, TX; Birmingham, United
Kingdom
In
patients with baseline HbA1c
³8%, orlistat
had a beneficial effect on HbA1c
levels, FPG and waist circumference (a marker of visceral
adiposity). orlistat,
in combination with diet, represents a clinically beneficial
adjunct to anti-diabetic therapy for overweight or obese patients
with T2D who have inadequate glycemic control
Effect
of Orlistat on
Post-Prandial Glucose Levels in Overweight or Obese
Patients with Type 2 Diabetes
MARKOLF
HANEFELD. Dresden, Saxony, Germany
ORL
in combination with anti-diabetic agents and a mildly
reduced-calorie diet has a beneficial effect on PPG levels. At
both 6 and 12 months, this effect was significantly greater than
that of anti-diabetic agents and a mildly reduced-calorie diet
alone.
Effect
of Orlistat in
Patients with Type 2 Diabetes at Differing Baseline HbA1c
Levels
RALPH
DE FRONZO, F. XAVIER PI-SUNYER. San Antonio, TX; New York, NY
Orlistat
is a non-systemically acting lipase inhibitor that has been shown
to improve glycemic control, reduce weight and improve other
cardiovascular risk factors in patients with type 2 diabetes
(T2D).
Orlistat
has a beneficial effect on HbA1c,
and as with all other oral hypoglycemic agents, the decrement in
HbA1c
is proportional to the starting HbA1c.
Orlistat, in combination with diet, represents a useful adjunctive
treatment in T2D patients at all levels of glycemic control.
Effect
of Orlistat on Insulin Resistance
in Patients with Type 2 Diabetes with Baseline HbA1c
levels >8%
AILA
RISSANEN, PRISCILLA HOLLANDER. Helsinki, Etela-Suomen Laani,
Finland; Dallas, TX
The
addition of treatment with ORL 120 mg or placebo (PL) tid plus a
mildly reduced-calorie diet (500-600 kcal/day deficit) for up to 1
year were pooled. The insulin resistance index was calculated by
the homeostatic model assessment (HOMA) method.
At
endpoint (24 or 52 weeks), ORL significantly reduced the insulin
resistance index compared with PL in the overall patient
population. Similar decreases in insulin resistance index were
observed for ORL vs PL within the sub-populations treated with
different anti-diabetic medications. Mean (least squares mean)
insulin resistance index at baseline, change vs baseline and
difference vs placebo are shown.
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