Orlistat: in the prevention and treatment of type 2 diabetes mellitus.
Orlistat is a nonsystemically acting gastric and pancreatic lipase inhibitor that limits the absorption of dietary fat. A retrospective pooled analysis of three 2-year, double-blind, randomised, placebo-controlled trials involving patients with obesity revealed that orlistat recipients were more likely to experience an improvement, and less likely to experience a deterioration, in glucose tolerance status than placebo recipients. In comparison with placebo, orlistat recipients had significantly greater reductions in glycosylated haemoglobin and fasting plasma glucose levels in large, double-blind, randomised, placebo-controlled studies of 24 to 52 weeks' duration involving patients with obesity and type 2 diabetes mellitus. In one such study, the dosage of concomitant sulphonylureas was able to be reduced in more orlistat than placebo recipients (43.2 vs 28.9%), with discontinuation of sulphonylurea therapy achieved in 11.7% of orlistat recipients. The most common adverse effects reported in orlistat recipients with type 2 diabetes mellitus relate to the gastrointestinal system and are similar to those reported in studies involving patients without type 2 diabetes mellitus.
Keating
G M
GM
Adis International Limited, Auckland, New Zealand. demail@adis.co.nz
Jarvis
B
B
D000284:Administration, Oral; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000517:prevention & control*; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006442:Glycated Hemoglobin; D006801:Humans; D007783:Lactones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D000077403:Orlistat; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D001786:Blood Glucose; D004791:Enzyme Inhibitors; D006442:Glycated Hemoglobin; D007783:Lactones; D000077403:Orlistat