Weight-Loss Therapy in Type 2 Diabetes: Effects of Phentermine and Topiramate Extended Release

Abstract Background Extended-release naltrexone/bupropion (NB) is indicated for chronic weight management. Incretin agents are recommended for patients with type 2 diabetes. This analysis looked at the add-on of NB to incretins to see if weight loss could occur in patients already stabilized on incretin agents. Methods This was a post-hoc analysis of NB vs. placebo (PL) among subjects with type 2 diabetes stable on an incretin agent prior to randomization in a double-blind, PL-controlled cardiovascular outcome trial (N = 1317). Results Over 1 year, mean weight loss was significantly greater among NB patients vs. PL among those taking DPP-4i (mean absolute difference 4.6% [p < 0.0001]) and those taking GLP-1RAs (mean absolute difference 5.2%, p < 0.0001). Proportions of subjects achieving 5% weight loss were significantly greater for NB vs. PL at weeks 26 and 52 among those taking DPP-4is or GLP-1RAs. There were no significant differences in effectiveness observed between NB + DPP-4i and NB + GLP-1RA or between PL + DPP-4i and PL + GLP-1RA in any of the analyses. Serious adverse events were reported by 9.1% and 11.1% for PL + DPP-4i and PL + GLP-1RA, respectively, and 13.3% and 12.4% of NB + DPP-4i and NB + GLP-1RA, respectively. Conclusion NB appears to be effective in reducing weight in patients with T2DM and obesity/overweight who are taking DPP-4ihibitors or GLP-1RA. The SAE rates in all arms of this analysis were lower than have been reported in other cardiovascular outcome trials in type 2 diabetes.

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Severe nonalcoholic steatohepatitis and type 2 diabetes: liver histology after weight loss therapy in a randomized clinical trial

Current Medical Research and Opinion ◽

10.1080/03007995.2018.1547696 ◽

2018 ◽

Vol 35 (1) ◽

pp. 157-165 ◽

Cited By ~ 3

Author(s):

Kuat Oshakbayev ◽

Bakytzhan Bimbetov ◽

Kenzhegul Manekenova ◽

Gulnara Bedelbayeva ◽

Khalit Mustafin ◽

...

Keyword(s):

Type 2 Diabetes ◽

Clinical Trial ◽

Weight Loss ◽

Randomized Clinical Trial ◽

Nonalcoholic Steatohepatitis ◽

Liver Histology ◽

Weight Loss Therapy

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Reductions in Insulin Resistance are Mediated Primarily via Weight Loss in Subjects With Type 2 Diabetes on Semaglutide

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-02685 ◽

2019 ◽

Vol 104 (9) ◽

pp. 4078-4086 ◽

Cited By ~ 9

Author(s):

Vivian A Fonseca ◽

Matthew S Capehorn ◽

Satish K Garg ◽

Esteban Jódar Gimeno ◽

Oluf H Hansen ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Weight Loss ◽

Extended Release ◽

Outcome Measure ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Post Hoc ◽

The Relationship

AbstractContextSemaglutide, a once-weekly glucagon-like peptide-1 analog approved for use in patients with type 2 diabetes (T2D), demonstrated superior body weight (BW) reductions and decreased insulin resistance (IR) vs comparators across the Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN) 1–3 clinical trials.ObjectiveTo investigate the relationship between IR and BW across the SUSTAIN 1–3 trials.DesignPost hoc analysis of the SUSTAIN 1–3 trials.SettingThree hundred and eleven sites in 30 countries.Patients or other participants2432 subjects with T2D.InterventionsSemaglutide 0.5 or 1.0 mg, placebo or active comparator (sitagliptin 100 mg, exenatide extended release 2.0 mg).Main Outcome MeasureTo assess the extent of the effect on IR that is mediated (indirect effect) and not mediated (direct effect) by the effect on BW.ResultsAcross SUSTAIN 1–3, mean BW was significantly reduced with semaglutide 0.5 mg (3.7 kg to 4.3 kg; P < 0.0001) and semaglutide 1.0 mg (4.5 kg to 6.1 kg; P < 0.0001) vs comparators (1.0 kg to 1.9 kg). There were greater reductions in IR with semaglutide 0.5 mg (27% to 36%) and semaglutide 1.0 mg (32% to 46%) vs comparators (17% to 28%). Greater reductions in BW were generally associated with greater decreases in IR. The effect on IR was primarily mediated by weight loss (70% to 80% and 34% to 94%, for semaglutide 0.5 mg and 1.0 mg, respectively, vs comparator).ConclusionsSemaglutide consistently reduced BW and IR in subjects with T2D in SUSTAIN 1–3. In this analysis, IR improvement was positively associated with, and primarily mediated by, the effect of semaglutide on BW.

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Abstract #806359: SGLT 2 Inhibitors; Glycemic Control, Weight Loss and Safety Profile in Patients with Type 2 Diabetes, at Medicell Institute: a Private Care Facility

Endocrine Practice ◽

10.1016/s1530-891x(20)39691-9 ◽

2020 ◽

Vol 26 ◽

pp. 126

Author(s):

Erum Sohail

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Glycemic Control ◽

Safety Profile ◽

Care Facility ◽

Private Care

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Abstract #1141: Efficacy and Safety of Initial Combination Therapy with Canagliflozin (CANA) and Metformin Extended-Release (Met) in Drug-Naïve Patients with Type 2 Diabetes Mellitus (T2DM) By Latino/Hispanic Ethnicity

Endocrine Practice ◽

10.1016/s1530-891x(20)44270-3 ◽

2017 ◽

Vol 23 ◽

pp. 312

Author(s):

Jaime Davidson ◽

Julio Rosenstock ◽

Ujjwala Vijapurkar ◽

Michael Davies ◽

Anita Conner ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Combination Therapy ◽

Extended Release ◽

Efficacy And Safety ◽

Initial Combination Therapy ◽

Drug Naïve ◽

Initial Combination

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How to Maintain a Healthy Body Weight

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.76.4.208 ◽

2006 ◽

Vol 76 (4) ◽

pp. 208-215 ◽

Cited By ~ 10

Author(s):

Astrup

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Loss ◽

Body Weight ◽

Glycemic Index ◽

Dairy Products ◽

Weight Control ◽

Healthy Body Weight ◽

Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

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