Drug could provide new treatment approach for overweight people with diabetes

The drug rimonabant, can reduce bodyweight and improve control of blood glucose levels and other cardiovascular risk factors in people with type 2 diabetes, according to an Article in this week's issue of The Lancet. The findings suggest that this drug could be used as a new approach for treatment of diabetes where other drugs have failed.

Type 2 diabetes is usually diagnosed in adulthood and is treated with either dietary changes alone or drugs. Diabetes is associated with an increased risk of cardiovascular disease, and often coexists with other risk factors, such as abdominal obesity, unhealthy blood lipid levels, and raised blood pressure. The treatment of these risk factors is central to the management of type 2 diabetes.

In the latest study, Andre Scheen (University of Liege, Belgium) and colleagues investigated the effects of rimonabant on 1047 overweight or obese patients with poorly controlled type 2 diabetes, despite treatment with standard diabetes drugs. The patients were given a diet plan that provided slightly fewer calories than they needed and were advised to be more physically active, to help induce weight loss. They were also given either rimonabant--in a dose of either 5 mg per day or 20 mg per day--or a placebo. The patients followed this regimen for a year.

The investigators showed that after a year, patients given rimonabant lost significantly more weight than those given the placebo. Patients given the placebo lost an average of 1•4 kg compared with a weight loss of 2•3 kg in those given 5 mg per day of rimonabant and 5•3 kg in those given a 20 mg per day dose of the drug. Patients given rimonabant also had greater improvements in waist circumference, blood glucose control, blood lipids, and better appetite control than those given the placebo.

The authors conclude: "These findings support the use of 20 mg per day of rimonabant, in addition to diet and exercise, as a new approach to reduce bodyweight and improve blood glucose control as well as several other cardiovascular risk factors in overweight or obese patients with type 2 diabetes that was inadequately controlled by standard treatment."

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See accompanying Comment.

Professor Andre J Scheen, Department of Medicine, Service de Diabetologie (B35), Nutrition et Maladies Metaboliques, Centre Hospitalier de Liege, CHU Sart Tilman, B-4000 Liege, Belgium. T) +32 4 3667 238 Andre.Scheen@chu.ulg.ac.be


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