Treating diabetes and prediabetes by focusing on obesity management

Khaodhiar, Lalita; Cummings, Sue; Apovian, Caroline M.

doi:10.1007/s11892-009-0055-0

Cited by 49 publications

(36 citation statements)

References 52 publications

(59 reference statements)

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“…Meaningful weight loss has historically been more difficult to achieve among patients with type 2 diabetes than among those without diabetes (11,12,13). Nevertheless, current American Diabetes Association treatment guidelines recommend that individuals with type 2 diabetes achieve modest weight loss (5–7%) to improve glycemic control and reduce cardiovascular risk (25).…”

Section: Discussionmentioning

confidence: 99%

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Randomized Placebo‐Controlled Clinical Trial of Lorcaserin for Weight Loss in Type 2 Diabetes Mellitus: The BLOOM‐DM Study

O’Neil

Smith

Weissman

et al. 2012

Obesity

479

451

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Mellitus) study evaluated efficacy and safety of lorcaserin for weight loss in patients with type 2 diabetes. Secondary objectives included evaluations of glycemic control, lipids, blood pressure, and quality of life. This 1-year, randomized, placebo-controlled trial enrolled 604 patients 1:1:1 to placebo, lorcaserin 10 mg once daily (QD) or lorcaserin 10 mg twice daily (BID). Patients were treated with metformin, a sulfonylurea (SFU) or both; had glycated hemoglobin (HbA 1c ) 7-10%; were 18-65 years old; and had BMI 27-45 kg/m 2 . Patients received diet and exercise counseling. Safety monitoring included serial echocardiograms. Mean (± SD) age was 52.7 ± 8.7; 54.2% were women; 60.5% were white, 20.9% were African American, and 13.8% were Hispanic. Mean (± SD) weight was 103.6 ± 17.8 kg; BMI was 36.0 ± 4.5 kg/m 2 . Most patients (91.7%) took metformin; 50.2% took a SFU. More patients lost ≥5% body weight with lorcaserin BID (37.5%; P < 0.001) or lorcaserin QD (44.7%; P < 0.001) vs. placebo (16.1%; modified intent to treat (MITT)/last observation carried forward (LOCF)). Least square mean (± SEM) weight change was −4.5 ± 0.35% with lorcaserin BID and −5.0 ± 0.5% with lorcaserin QD vs. −1.5 ± 0.36% with placebo (P < 0.001 for each). HbA 1c decreased 0.9 ± 0.06 with lorcaserin BID, 1.0 ± 0.09 with lorcaserin QD, and 0.4 ± 0.06 with placebo (P < 0.001 for each); fasting glucose decreased 27.4 ± 2.5 mg/dl, −28.4 ± 3.8 mg/dl, and 11.9 ± 2.5 mg/dl, respectively (P < 0.001 for each). Symptomatic hypoglycemia occurred in 7.4% of patients on lorcaserin BID, 10.5% on lorcaserin QD, and 6.3% on placebo. Common adverse events were headache, back pain, nasopharyngitis, and nausea. Lorcaserin was associated with significant weight loss and improvement in glycemic control in patients with type 2 diabetes.Obesity ( articles intervention and PreventionThe BLOOM-DM (Behavioral Modification and Lorcaserin for Obesity and Overweight Management in Diabetes Mellitus) study had as its main objective the evaluation of the efficacy and safety of lorcaserin for weight loss in adults with type 2 diabetes treated with metformin and/or a sulfonylurea (SFU). Secondarily, the impact of lorcaserin on glycemic control was evaluated. Methods and Procedures study designThe study was conducted at 58 academic and private research sites in the United States between 27 December 2007 and 9 August 2010 under the guidelines of the Declaration of Helsinki. Institutional review boards reviewed and approved the protocol for each research site. All patients provided written informed consent before participation in the trial.The overall objective of the 1-year, randomized, double-blind, placebo-controlled trial was to evaluate the safety and efficacy of lorcaserin for weight loss in patients with type 2 diabetes when administered in conjunction with a lifestyle modification program. The prespecified coprimary endpoints were: (i) the proportion of patients achieving ≥5% reduction in baseline body weight at the end of 1 year, (ii) change in weight, and (iii) t...

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Section: Discussionmentioning

confidence: 99%

“…Weight loss of as little as 5% can significantly improve glycemic control, and may have beneficial effects on weight‐related comorbid conditions as well (9,10). Unfortunately, meaningful weight loss has historically been more difficult to achieve among individuals with diabetes than among nondiabetic populations (11,12,13).…”

Section: Introductionmentioning

confidence: 99%

Randomized Placebo‐Controlled Clinical Trial of Lorcaserin for Weight Loss in Type 2 Diabetes Mellitus: The BLOOM‐DM Study

O’Neil

Smith

Weissman

et al. 2012

Obesity

479

451

View full text Add to dashboard Cite

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“…In fact, weight loss of 5% or more has been linked to improvements in glycemic control, blood pressure, lipids, and quality of life (Pi-Sunyer, 2005;Khaodhiar et al, 2009). The fact that PAE effectively caused dose-related weight loss in the treated rats and reduced the risk of atherogenesis and coronary artery disease also highlights the anti-obesity, antihyperlipidemic and cardioprotective potentials of PAE.…”

Section: Discussionmentioning

confidence: 99%

The leaf and seed aqueous extract of Phyllanthus amarus improves insulin resistance diabetes in experimental animal studies

Adeneye

2012

Journal of Ethnopharmacology

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“…Prediabetes raises short term absolute risk of T2DM five to six fold. The development of T2DM can be delayed or sometimes prevented in obese individuals on losing weight [5]. According to American Diabetes Association (ADA), prediabetes is defined as impaired fasting glucose (IFG) ([100 mg/dl) but \126 mg/dl and impaired glucose tolerance (IGT) ([140 mg/dl) but \200 mg/dl [6].…”

Section: Introductionmentioning

confidence: 99%

Microalbuminuria in Obese Young and Middle Aged Population: A Potential Marker of Cardiovascular Risk

et al. 2016

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Microalbuminuria is an established cardiovascular risk indicator in diabetes, hypertension and the general population. There is lack of information on MAU in healthy obese Indian adults and an ongoing debate whether obese adults deserve targeted identification and clinical intervention for MAU and prediabetes. We aimed to screen the healthy obese, young (group I) and middle aged (group II) adults for prevalence of MAU and prediabetes and study its association with Framingham risk score. The study included 50 healthy obese young (20-30 years) and middle aged adults (31-50 years), attending the outpatient clinic of Dept. of Medicine for a duration of 2 months (July-August). The patients were screened for fasting blood sugar, lipid profile and MAU. Of the total patients 28 % had MAU, 32.14 % of which had prediabetes and 33.33 % had diabetes whereas 10 % were normoglycemic. The group I patients had 50 % cases of MAU and group II had 25 % patients with MAU. Group II 63.63 % pre-diabetics. The values of MAU obtained were correlated with age, gender, body mass index, systolic and diastolic blood pressure, FBS, waist to hip ratio using Pearson's Coefficient (p < 0.05). The 10 year CVD risk calculated using FRS in subjects with MAU was higher as compared to those without MAU. Thus we conclude that Indian, young and middle aged obese adults to be at a risk of prediabetes, MAU and CV risk warranting their routine screening for better clinical outcomes.

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Treating diabetes and prediabetes by focusing on obesity management

Cited by 49 publications

References 52 publications

Randomized Placebo‐Controlled Clinical Trial of Lorcaserin for Weight Loss in Type 2 Diabetes Mellitus: The BLOOM‐DM Study

Randomized Placebo‐Controlled Clinical Trial of Lorcaserin for Weight Loss in Type 2 Diabetes Mellitus: The BLOOM‐DM Study

The leaf and seed aqueous extract of Phyllanthus amarus improves insulin resistance diabetes in experimental animal studies

Microalbuminuria in Obese Young and Middle Aged Population: A Potential Marker of Cardiovascular Risk

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