Background: Most obese patients with type 2 diabetes have several components of metabolic syndrome that is associated with a marked increase in the risk of cardiovascular disease. Even modest weight reduction in the obese patients with type 2 diabetes may lessen the severity of cardiovascular risk factors as well as improving glycemic control. Aim of present study was to investigate the efficacy of orlistat in promoting weight reduction in obese patients with type 2 diabetes and to assess the effect on glycemic control, abdominal obesity and metabolic parameters.
Methods: This study is a prospective, open-labled, multicenter, non-comparative trial. 120 mg orlistat was administered orally three times a day for 24 weeks to 90 obese patients with type 2 diabetes. All patients who met the selection criteria were maintained for 24 weeks on moderate hypocaloric diet (-600 kcal/day deficit). We compared the changes in metabolic parameter before and after treatment.
Results: At the end of treatment, 73 completed this study. The mean weight change from baseline was -2.8 kg (P < 0.001). There were also significant improvement of glycemic control (HbA1c:-0.87%, P < 0.01), fasting insulin, total cholesterol, LDL cholesterol (P < 0.001). Treatment with orlistat also improved several metabolic parameters, namely waist circumference (-5.48 ± 0.54cm, P < 0.001), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P = 0.000), fasting plasma glucose (P = 0.027). But there was decrease of HDL cholesterol level. There were mild gastrointestinal troubles, but no serious side effect.
Conclusions: We suggest that orlistat is an effective treatment modality in obese Korean type 2 diabetes with respect to significant weight loss, improved glycemic control, improved abdominal obesity and metabolic parameters without adverse effects.

Keywords: Obesity, Type 2 Diabetes Mellitus, Metabolic Syndrome, Orlistat (XenicalⓇ,)