Better glycemic control leads to weight loss, which leads to better gly-cemic control—the primary goal in diabetes. A study from Mexico City suggests that patients are helped by an appetite suppressant, sibutramine HCl monohydrate (Meridia®, Abbott).
Forty-four patients with type-2 (non-insulin-dependent) diabetes had been taking glibenclamide monotherapy for at least two weeks. They were randomly assigned to receive sibutramine 10 mg or a placebo once daily. After 12 months of treatment with sibutramine and gliben-clamide, the diabetic patients lost 4 kg (11 pounds), their body mass index (BMI) decreased from 29.9 to 28.2 kg/m2, and they lost 4 cm (1.5 inches) around the waist. Plasma fasting glucose concentrations declined from 140.4 to 114.2 mg/dl, and glycosylated hemoglobin (Hb A1c) fell from 8.9% to 8.3%.
The placebo patients experienced similar but smaller changes. They lost 1.4 kg (3.1 pounds); 0.6 kg/m2 in BMI; and 1.3 cm (0.5 inch) in waist circumference. Fasting glucose levels fell from 140.7 to 123.9 mg/dl, but Hb A1c values rose from 9.0% to 9.1%.