ADA: Orlistat Reduces
Type 2 Diabetes in High-Risk Obese Patients
Treatment with orlistat in conjunction with lifestyle
changes decreases the rate of type 2 diabetes
in obese patients with impaired glucose tolerance
(IGT) or metabolic syndrome.
Ralph DeFronzo, MD, from University of Texas
Health Science Center, in San Antonio, Texas,
reported at the 63rd Scientific Sessions of the
American Diabetes Association, the effects of
orlistat on the onset of type 2 diabetes in patients
with IGT or metabolic syndrome, enrolled in the
XENical in the prevention of Diabetes in Obese
Subjects (XENDOS) study.
The XENDOS study is a 4-year, prospective, randomised,
double-blind trial in which 3,304 obese Swedish
patients with normal glucose tolerance (79%) or
IGT (21%) received three times daily dosing of
orlistat 120 mg or placebo in combination with
lifestyle changes.
The diagnosis of metabolic syndrome was established
on the basis of the Adult Treatment Panel III
criteria, and type 2 diabetes was diagnosed on
the basis of a single 2-hour oral glucose tolerance
test (OGTT) whole-blood glucose measurement greater
than or equal to 10.0 mmol/L.
After 4 years of treatment, and in all patients,
orlistat significantly decreased the progression
to type 2 diabetes compared to placebo. The hazard
ratio (0.627) corresponded to a 37.3% decrease
in the risk of developing diabetes in patients
receiving orlistat compared with placebo.
Treatment with orlistat also decreased the risk
of progression to type 2 diabetes by 45% compared
with placebo in patients with IGT at baseline,
irrespective of metabolic syndrome status.
In patients with baseline normal glucose tolerance,
the rate of progression to type 2 diabetes was
low in both the orlistat and placebo groups.
Results also showed that orlistat treatment greatly
decreased the progression to type 2 diabetes compared
with placebo in patients with and without metabolic
syndrome, with a reduction of 36% and 40%, respectively.
"The study is the first ever to show that
a weight-loss medication can prevent or postpone
the onset of type 2 diabetes in at-risk patients,"
Dr. DeFronzo concluded.
This study was supported by Hoffmann-La Roche
of Nutley, New Jersey.
[Study title: XENDOS: Onset of Type 2 Diabetes
in Obese Patients with Normal Glucose Tolerance/IGT
and Metabolic Syndrome. Abstract 1706]
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