Xenical Drops Weight, Blood Sugar in Diabetics

From the WebMD Archives

Sept. 12, 2001 -- One of the newcomers to the world of weight loss not only helps shed pounds, but also can help overweight people with diabetes drop their blood sugar. Xenical even allowed some people to take less diabetes medication.

Frederic Carriere, PhD, tells WebMD that Xenical works differently from previous weight loss drugs by reducing the absorption of fat from the intestines. And since the drug does not get into the bloodstream, it lacks the serious nervous system and heart effects of appetite suppressants such as the combination treatment fen-phen.

Carriere says that Xenical does, in fact, seem to be effective for reducing the chance of heart disease by lowering cholesterol, especially in overweight people with type 2 diabetes, the most common type of the blood sugar problem that frequently affects overweight people. Carriere heads the pancreatic lipase structure-function group at the Laboratory of Enzymatic Lipolysis in Marseille, France.

"Achieving sufficient weight loss is a vital first step in the treatment of people with type 2 diabetes, although less than 10% of people with type 2 diabetes manage to achieve sufficient weight loss through diet alone," stated Markholf Hanefeld, MD, lead author of a study from the University of Dresden in Germany, in a news release.

In Hanefeld's study of overweight people with type 2 diabetics, everyone was treated with a mildly reduced calorie low-fat diet. Either Xenical or a placebo pill was given to more than 360 people for one year. Those on Xenical lost an average of 12 lbs, about twice the weight that the people taking the dummy pill lost. The Xenical group also saw more slimming of their waistline than those taking placebo.

The results of the study were presented at the European Association for the Study of Diabetes meeting in Glasgow, Scotland.

Weight loss results were similar in another study by Alfredo Halpern, MD, of 338 people at the University of Sao Paulo in Brazil. In both studies, most people took Xenical without any trouble, and the drug produced significant drops in blood sugar, cholesterol, and blood pressure. In addition, many people were able to cut back on their other diabetes medications.

Although these results look very promising, experts tell WebMD that only time will determine if Xenical can lead to actual improvements in heart disease and heart attacks.

But the FDA is already considering adding Xenical to the current arsenal of drugs to fight type 2 diabetes.

One concern about Xenical is that it can cause severe diarrhea to the point of losing some needed vitamins from the intestines. So experts caution that Xenical should be only a part of a weight loss program, since a low-fat diet will help prevent the diarrhea. "Xenical should always be combined with a balanced, low-fat diet monitored by a health professional," Leila Karhunen, PhD, a nutritionist at University of Kuopio in Finland, tells WebMD.

In some people, weight loss may reduce risk of developing diabetes. So many doctors already are using Xenical for this reason, explains Dan Weiss, MD, assistant clinical professor of medicine at Case Western Reserve University in Cleveland.

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