Improvement of glycaemic control with rebound following orlistat initiation and cessation associated with minimal weight change

S. González, E. S. Kilpatrick, Stephen Atkin

Research output: Contribution to journalArticle

Abstract

A 57-year-old Caucasian woman with Type 2 diabetes treated for seven years with diet and oral combination hypoglycaemic therapy was referred because of the progressive deterioration of glycaemic control. She was obese (77 kg, BMI = 39.9), hypertensive, hypercholesterolaemic with marked osmotic symptoms (HbA 1c 12.2%), therefore she was started on insulin (Human Mixtard 30 b.d.) with metformin therapy. Dietary counselling, recommendations to increase physical activity, and supervised self-injection technique with titration of her insulin were also provided. She was routinely followed-up to assess her progress. Two years later, her glycaemic control remained suboptimal. Average HbA 1c was 10.4% despite an increasingly high dose of insulin (94 units/day) although it improved when metformin was increased to 1 g t.d.s. (HbA 1c = 9.3%). Her BMI progressively rose from 39.9 to 42.1 (77 to 82.5 kg) despite dietary advice. A trial of orlistat (three months) was commenced, after intensive dietary counselling, that reduced her body weight by 1.5 kg (2% reduction, BMI 41.3). However, her HbA 1c improved by 0.5% (from 9.3 to 8.8%). Six months after orlistat was stopped her HbA 1c rose to 10.5% and weight increased to 81.8 kg (BMI 41.8). Despite the orlistat treatment broaching NICE guidelines should it have been continued?

Original languageEnglish
Pages (from-to)344-345
Number of pages2
JournalDiabetic Medicine
Volume22
Issue number3
DOIs
Publication statusPublished - Mar 2005
Externally publishedYes

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Keywords

  • Diabetes
  • Glycaemic control
  • HbA
  • Orlistat
  • Weight

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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