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Weight and blood pressure response to weight management and sibutramine in diabetic and non‐diabetic high‐risk patients: an analysis from the 6‐week lead‐in period of the sibutramine cardiovascular outcomes (SCOUT) trial
Author(s) -
Van Gaal L. F.,
Caterson I. D.,
Coutinho W.,
Finer N.,
Maggioni A. P.,
Sharma A. M.,
TorpPedersen C.,
Ge H.,
Moran S. A.,
Shepherd G. M.,
James W. P. T.
Publication year - 2010
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2009.01090.x
Subject(s) - sibutramine , medicine , diabetes mellitus , blood pressure , weight loss , overweight , type 2 diabetes , insulin , weight management , cardiology , endocrinology , obesity
Objective: To assess treatment responses to sibutramine and weight management in diabetic patients during the lead‐in period of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Methods: SCOUT is an ongoing, prospective, randomized, double‐blind, placebo‐controlled outcome trial in cardiovascular high‐risk overweight/obese patients. A total of 10 742 patients received single‐blind sibutramine and individualized weight management during the 6‐week lead‐in period; 84% had a history of type 2 diabetes mellitus and additional co‐morbidities. Post‐hoc analyses assessed anthropomorphic and vital sign responses between patients with and without diabetes. Results: Concomitant antidiabetic medication use was reported by 86% of the diabetic patients (approximately 30% required insulin–alone or in combination). Body weight and waist circumference decreased in diabetic patients: median 2.1 kg; 2.0 cm (both men and women); for those on insulin: 1.9 kg; 1.5/2.0 cm (men/women); without insulin: 2.3 kg; 2.0 cm (both men and women); blood pressure (BP) was also reduced (median systolic/diastolic 3.5/1.0 mmHg) with larger reductions in diabetic patients who were hypertensive and/or lost the most weight (>5%). In diabetic patients who entered with BP at target (<130/<85 mmHg) but did not lose weight (N = 245), increases of 3.5/2.0 mmHg were observed. Non‐diabetic patients had greater weight losses (2.5 kg) but smaller reductions in BP (systolic/diastolic −2.5/−0.5 mmHg). Pulse rate increases were less in diabetic vs. non‐diabetic patients (1.5 vs. 2.0 bpm). Conclusion: In these high‐risk diabetic patients, sibutramine and lifestyle modifications for 6 weeks resulted in small, but clinically relevant, median reductions in body weight, waist circumference and BP. A small median increase in pulse rate was recorded.