No Magic Pill For Weight Loss in Diabetics

In 14 trials pharmacotherapy can only show modest weight loss and long-term effects are unclear.

The findings are based on a meta-analysis of data from 14 trials in which drug therapy was used as the main weight loss strategy for adults with type 2 diabetes. The trials included a total of 2231 participants and the analysis focused on three agents for which sufficient data were available: fluoxetine, orlistat, and sibutramine. All three drugs were associated with modest reductions in weight over 26 to 52 weeks, lead author Dr. Susan L. Norris, from the Centers for Disease Control and Prevention, and colleagues note. The weight loss ranged from 2.6 to 4.5 kg or 2% to 3% of baseline body weight.

Treatment with these agents was also linked to slight reductions in glycated hemoglobin levels, ranging from 0.4% to 1.0%, the researchers found.

Although the drugs were generally well tolerated, certain side effects were common with each. For example, gastrointestinal side effects were often seen with orlistat, whereas palpitations were common with sibutramine.

“Further work is needed to examine whether the combination of lifestyle modification and pharmacotherapy improves the efficacy of drug therapy, whether such combinations are synergistic or additive, and what dosage schedules and sequencing of the two interventions are optimal,” Dr. Norris’ team concludes. Arch Intern Med 2004;164:1395-1404.

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DID YOU KNOW:
New York’s Rich Living Longer Than Poor – Life expectancy in the city’s poorest neighborhoods was eight years shorter than in its wealthiest neighborhoods in 1991, up from 10 years shorter in 1990, according to a new report by the health department. New Yorkers in the city’s lowest income neighborhoods had a life expectancy of 74.5 years, compared with 81.1 years in the highest income neighborhoods, the study found. The average life expectancy in the United States is 77.2 years. Those in the poorest neighborhoods were four times more likely to report poor health overall and three times as likely to die from diabetes as those in the wealthiest neighborhoods.