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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

2009; Wiley; Volume: 12; Issue: 1 Linguagem: Inglês

10.1111/j.1463-1326.2009.01090.x

ISSN

1463-1326

Autores

Luc F. Van Gaal, Ian D. Caterson, Walmir Coutinho, Nick Finer, Aldo P. Maggioni, Arya M. Sharma, C. Torp‐Pedersen, Hong Ge, S. A. Moran, G Shepherd, W. P. T. James,

Tópico(s)

Diabetes, Cardiovascular Risks, and Lipoproteins

Resumo

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.

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