Sibutramine and Weight Loss in Obese People With Type 2 Diabetes

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Effect of sibutramine on weight management and metabolic control in type 2 diabetes: a meta-analysis of clinical studies, by R. Vettor and colleagues. Diabetes Care 28:942-949, 2005.

What is the problem and what is known about it so far?

Since the 1970s, there has been a 50% increase in the percentage of Americans who are overweight or obese. With the increase in the number of overweight and obese people, there has been a huge increase in the number of people who have type 2 diabetes. Being overweight makes it harder to control blood glucose and can lead to heart problems. Treatment with sibutramine, a weight loss drug, could improve the health of overweight or obese people who have type 2 diabetes and help lower their risk for heart problems.

Why did the researchers do this particular study?

To look at the results of studies on how sibutramine affected weight loss and blood glucose in obese people with type 2 diabetes. Sibutramine is a drug that affects chemicals in the body that control appetite. Doctors prescribe it as a short-term aid to obese patients who are trying to lose weight by dieting and exercising.

How was the study done?

The authors searched through various databases to find articles on studies that dealt with the treatment of obesity with sibutramine in people with type 2 diabetes. They looked at eight studies that included results on weight, blood glucose, triglycerides (fats in the blood), cholesterol (a waxy fat-like substance in the blood), blood pressure, and heart rate.

Who was studied?

The eight studies included 1,093 obese patients with type 2 diabetes. Of these patients, 552 were treated with sibutramine and 541 were given a placebo, or a pill that has no effect.

What did the researchers find?

The patients who were treated with sibutramine lost more weight than the patients who were given a placebo. Sibutramine also lowered blood glucose and improved triglycerides and HDL cholesterol (the "good" cholesterol). However, diastolic blood pressure -- the bottom number in a blood pressure reading -- and heart rate were slightly higher in the patients who received sibutramine.

What were the limitations of the study?

The authors looked at only eight studies, and each study was slightly different. For example, one study looked at women only. However, all of the studies had similar results.

What are the implications of the study?

The results of the eight studies show that sibutramine helps improve weight loss, blood glucose, HDL cholesterol, and triglycerides in obese people with type 2 diabetes. These effects lower the chances of having heart problems. For most obese people with type 2 diabetes, losing weight and keeping a healthy weight may be the best way to improve their health. To read the American Diabetes Association and the American College of Cardiology recommendations on the use of sibutramine to treat obesity in people with diabetes, go to http://www.diabetes.org/weightloss-and-exercise.jsp.

FOR MORE INFORMATION

101 Weight Loss Tips for Preventing and Controlling Diabetes , by Anne Daly, Linda M. Delahanty, and Judith Wylie-Rosett (Alexandria, Va., ADA, 2002).

Weight Loss Matters

A randomized trial of sibutramine in the management of obese type 2 diabetic patients treated with metformin, by S.J. McNulty and colleagues. Diabetes Care 26:125–131, 2003.

One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes, by J.B. Redmon and colleagues. Diabetes Care 26:2505–2511, 2003.