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Göteborgs universitets publikationer

Weight loss and metabolic effects of topiramate in overweight and obese type 2 diabetic patients: randomized double-blind placebo-controlled trial

Författare och institution:
Björn Eliasson (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Soffia Gudbjörnsdottir (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); J. Cederholm (-); Y. Liang (-); F. Vercruysse (-); Ulf Smith (Institutionen för medicin, avdelningen för molekylär och klinisk medicin)
Publicerad i:
Int J Obes (Lond), 31 ( 7 ) s. 1140-7
0307-0565 (Print)
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
OBJECTIVE: To examine the metabolic effects and body composition changes after topiramate treatment of obese type 2 diabetic patients (DM2) for 11 months. DESIGN AND SUBJECTS: Thirty-eight DM2 on diet or sulfonylurea treatment participated in this randomized double-blind placebo-controlled trial. Thirteen placebo-treated and nine topiramate-treated patients completed the trial. Patients were randomized to treatment with topiramate 96 mg b.i.d. or placebo (6-week run-in phase, 2-months titration phase, 9-months maintenance phase). MEASUREMENTS: Insulin sensitivity was measured with euglycaemic hyperinsulinemic clamps. Weight, HbA1c, fasting glucose, blood lipids and safety variables were measured at regular intervals. Body composition was determined with computerized tomography. Meal tests were performed to evaluate postprandial glucose and insulin levels. Three-day diet recalls were carried out to evaluate energy ingestion. RESULTS: The mean age was 58.6+/-7.1 years, body weight 98.1+/-16.1 kg, BMI 33.0+/-4.5 kg/m(2), and glycosylated hemoglobin (HbA1c) 7.3+/-0.9%. In topiramate-treated patients, there were significant reductions in HbA1c (1.1+/-0.9%), fasting plasma glucose, body weight (-6.6+/-3.3%), as well as body fat, lean body mass, postprandial glucose and free fatty acid levels but there were no significant changes in insulin sensitivity. The daily average energy intake decreased more in the topiramate group than in the placebo group. Paresthesia and central nervous system-related side effects were the main causes for the dropout rate. CONCLUSIONS: Topiramate treatment of overweight DM2 reduced body weight and body fat, and was associated with a marked improvement in glycaemic control whereas no significant improvement in insulin-stimulated glucose uptake was demonstrated. Further studies are required to clarify whether this effect might occur through changes in insulin sensitivity in the liver and/or pancreatic insulin secretion.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Endokrinologi och diabetes ->
Body Mass Index, Case-Control Studies, Diabetes Mellitus, Type 1/*drug therapy, Diabetes Mellitus, Type 2/*drug therapy, Female, Hemoglobin A, Glycosylated/analysis, Humans, Hypoglycemic Agents/administration & dosage/*therapeutic use, Insulin/administration & dosage/*analogs & derivatives/therapeutic use, Insulin, Isophane/administration & dosage/*therapeutic use, Male, Middle Aged, Regression Analysis, Retrospective Studies, Sensitivity and Specificity, Sex Factors
Postens nummer:
Posten skapad:
2008-12-19 13:17
Posten ändrad:
2011-01-20 09:59

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