Reduction of Visceral Adipose Tissue and Improvement of Metabolic Indices: Effect of Dexfenfluramine in NIDDM

Increased visceral adipose tissue is thought to contribute to impaired glucose tolerance. We studied 10 men with non‐insulin dependent diabetes (NIDDM) before and after a 12‐week intervention study using dexfenfluramine. Subjects had a mean body mass index (BMI) of 26.4 ± 1.7 kg\m 2 and had an abdominal distribution of body fatness (waist‐to hip ratio >0.9). Anthropometric indices, biochemistry, macronutrient intake from 7‐day food records as well as a euglycaemic glucose clamp and magnetic resonance imaging (MRI) were performed at week 0 and week 12. Abdominal adipose tissue area measured by MRI was reduced from 854 ± 270 cm 2 to 666 ± 231 cm 2 (p=0.003) due mainly to a selective 32% reduction in visceral fat area from 484 ± 230 cm 2 to 333 ± 72 cm 2 (p=0.002). Insulin sensitivity improved from 0.29 ± 0.13 [min −1 (mU/L)] to 0.54 ± 0.21 [min −1 (mU/L)] (p=0.01) and C‐peptide levels reduced from 0.77 ± 0.24 μmol/L to 0.58 ± 0.15 μmol/L (p=0.002). The reductions in fasting glucose and glycated haemoglobin failed to achieve significance. Fasting total cholesterol and triglyceride levels significantly reduced (p=<0.001 and p=0.021 respectively). There was a reduction in total energy intake (p=0.005) due to a significant reduction in calories obtained from fat (p<0.001). Thus dexfenfluramine was shown to be a useful adjunct therapy for the reduction of visceral fat in abdominally‐obese men with NIDDM with an associated improvement in insulin sensitivity.