Orlistat in the prevention of diabetes in the obese patient

Figures & data

Table 1 Modifiable and nonmodifiable risk factors for implementation of T2DM prevention programs

Modifiable factors	Non-modifiable factors
Obesity (mainly abdominal adiposity)	Ethnicity
Physical inactivity	Age
Smoking	Gender
Low fiber content of the diet	Genetic factors
High saturated fat/high trans fat in the diet/high processed meat intake	Prior glucose intolerance/gestational diabetes
Low magnesium intake	Low birth weight
Low coffee/alcohol intake	Hypertension
Psychosocial stress	High triglyceride/Low HDL cholesterol

Figure 1 Incidence of T2DM by study group in XENDOS study. Cumulative incidence is shown in all obese patients and only in obese patients with impaired glucose tolerance at baseline. The decrease in the risk of developing diabetes with orlistat plus lifestyle intervention compared with placebo plus lifestyle intervention is indicated. P values shown are for the log-rank test. Copyright © 2004. Reproduced with permission from Torgerson JS, Hauptman J, Boldrin MN, et al. 2004. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care, 27:155–61. Erratum in: Diabetes Care, 2004 27:856.

Table 2 Evidence for the benefits in carbohydrate metabolism and T2DM prevention achieved with orlistat treatment

Putative factor implicated in T2DM prevention with orlistat	Reference
Reduction in free fatty acid levels	Tan et al 2002; Kelley et al 2004
Reduction of proinflamatory adipocytokine levels	Samuelsson et al 2003; Valsamakis et al 2004
Enhancement in anti-inflammatory adipocytokine levels	Valsamakis et al 2004
Enhancement in incretin levels	Damci et al 2004

TorgersonJSHauptmanJBoldrinMNXENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patientsDiabetes Care20042715561 Erratum in: Diabetes Care, 2004 27:85614693982

 PubMed Web of Science ®Google Scholar

TanKTsoATamSAcute effect of orlistat on post-prandial lipaemia and free fatty acids in overweight patients with type 2 diabetes mellitusDiabet Med200219944812421432

 PubMed Web of Science ®Google Scholar

KelleyDEWilliamsKPriceJPlasma fatty acids, adiposity and variance of skeletal muscle insulin resistance in type 2 diabetes mellitusJ Clin Endocrinol Metab20018654121911701715

 PubMed Web of Science ®Google Scholar

SamuelssonLGottsaterALindgardeFDecreasing levels of tumour necrosis factor alpha and interleukin 6 during lowering of body mass index with orlistat or placebo in obese subjects with cardiovascular risk factorsDiabetes Obes Metab2003519520112681027

 PubMed Web of Science ®Google Scholar

ValsamakisGMcTernanPGChettyRModest weight loss and reduction in waist circumference after medical treatment are associated with favorable changes in serum adipocytokinesMetabolism200453430415045687

 PubMed Web of Science ®Google Scholar

DamciTYalinSBalciHOrlistat augments postprandial increases in glucagon-like peptide 1 in obese type 2 diabetic patientsDiabetes Care20042710778015111524

 PubMed Web of Science ®Google Scholar