Influence of Orlistat on Efficacy of Complex Treatment in Patients with Type 2 Diabetes Mellitus and Obesity
Background. Reasons of ineffective treatment of obesity in many cases are found not enough out. It is known also, that the use of numerous methods for body weight reducing arrive at the satisfactory stable results of treatment less than in 20 % cases. It grounds the necessity of further researches for the study of factors that influence on forming of obesity, the correction of that would result in proof control after body weight.
Objective of the study — to estimate influence of decline of body weight on metabolic parameters and secretory activity of fatty tissue in patients with type 2 diabetes mellitus with obesity.
Materials and Methods. Under a supervision there were 57 patients. The patients of the first group (n = 38) received diet therapy and metformin. Patients of the second group (n = 19), additionally to the diet therapy and metformin, received orlistat (Xenical) in a dose on one capsule (120 mg) 2–3 times daily. Before and 6 months after treatment we conducted the anthropometric measuring, estimated the blood lipid spectrum, carbohydrate exchange, and also content of immunoreactive insulin, leptin, index of insulin resistance HOMA-IR.
Results. In the most examined persons (84.2 %) there was hyperinsulinemia that testifies to insulin resistance (index of НОМА-IR increased in all patients). Level of immunoreactive insulin is closely associated with the indexes of atherogenic profile of plasma. Hyperleptinemia was detected in 98.2 % patients. Application of orlistat resulted in the decline of index of insulin resistance on 43 % from baseline, while in patients of the first group (diet therapy and metformin) this index on the average on a group rose on 2 %.
Conclusions. On a background the additional administration of orlistat to the standard treatment of type 2 diabetes mellitus (diet therapy and metformin) we obtained weight loss on 4.67 % (that averages 5.17 ± 0.59 kg). Administration of orlistat is accompanied by reduction of leptin level on 6.8 %, immunoreactive insulin on 39 %, index of HOMA-IR on 43 % from initial values. On a background the improvement of diabetes mellitus compensation we observed the reduction of daily dose of metformin (in 16 % patients).
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