Diabesity: Are Weight Loss Medications Effective?

Eventos Médicos

Diabesity: Are Weight Loss Medications Effective?

por site em 29 de abril de 2008


Reprodução do artigo publicado pelos doutores Alfredo Halpern e Márcio Mancini publicado na revista Treat Endocrinology, em maio de 2005. Segundo os autores, a obesidade é um dos grandes fatores que implicam no aparecimento e no controle do diabetes tipo 2. No artigo, sugerem o uso de medicamentos anti-obesidade como preventivo, pois podem melhorar as taxas de glicemia e possibilitar, ainda, a redução ou suspensão das medicações antidiabéticas normalmente utilizadas.

(O artigo está todo em inglês, conforme foi publicado.)

Autores

* Alfredo Halpern – Medical School, University of São Paulo, São Paulo, Brazil
* Marcio C. Mancini – Obesity and Metabolic Diseases Group at the Medical School Clinics Hospital, University of São Paulo, São Paulo, Brazil

Abstract

Weight reduction has been shown to improve glycemic control and cardiovascular risk factors associated with insulin resistance in obese individuals with type 2 diabetes mellitus. Therapeutic options for these patients include promoting weight loss (non-pharmacologic and pharmacologic treatment) and improving glycemic control, as well as treating common associated risk factors such as arterial hypertension and dyslipidemias. This article provides an overview of anti-obesity drugs used in the treatment of obese individuals with type 2 diabetes.

The most widely investigated drugs, sibutramine and orlistat, result in modest, clinically worthwhile weight loss, with demonstrable improvements in many co-morbidities, among them, type 2 diabetes. Clinical trials with these anti-obesity medications in cohorts of obese diabetic patients have been reviewed as well as cathecolaminergic agents (diethylpropion [amfepramone], fenproporex, mazindol, ephedrine-caffeine combination), serotoninergic drugs (fenfluramine, dexfenfluramine, fluoxetine), and other drugs that have some action on weight loss (the antidiabetic agent metformin, anti-epileptic agents topiramate and zonisamide, and the antidepressive bupropion [amfebutamone]). These trials show variable benefits in terms of effects on glucose profiles.