The addition of orlistat to a conventional weight loss regimen significantly improved oral glucose tolerance and slowed the rate of progression from impaired glucose tolerance to type 2 diabetes, a study has found (Archives of Internal Medicine 2000;160:1321).
A pooled analysis of three two-year randomised, controlled trials was used by Dr Steven Heymsfield (Columbia university of Physicians and Surgeons, New York, US) and colleagues to examine the effects of orlistat on glucose tolerance. The analysis included a total of 675 obese adults, who received a low energy diet and either orlistat or placebo. The researchers found that orlistat improved glucose tolerance and progression to diabetic status. Of the patients with impaired glucose tolerance at baseline, 71.6 per cent who received orlistat had normal glucose tolerance at the end of the treatment period compared with 49.1 per cent of the placebo group. Progression to diabetic status occurred in 3.0 per cent of patients treated with orlistat compared with 7.6 per cent of the placebo group.
The authors conclude that the study "strongly supports" the hypothesis that relatively small, long-term body weight loss significantly improves glucose tolerance and reduces the rate of diabetes onset in obese subjects. The orlistat group "lost more weight, experienced improved categorical glucose tolerance status and showed improved serum insulin and glucose levels". The researchers say: "Even modest pharmacologically facilitated weight loss produces important metabolic benefits. Antiobesity pharmacotherapy may, therefore, offer an additional therapeutic option for the prevention of diabetes."