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

Fingerprint

Metformin
Insulin
Weights and Measures
Counseling
Hypoglycemic Agents
Type 2 Diabetes Mellitus
Therapeutics
Body Weight
Guidelines
Exercise
Diet
Injections
orlistat
insulin, pork; isophane insulin, pork drug combination 30:70

Keywords

  • Diabetes
  • Glycaemic control
  • HbA
  • Orlistat
  • Weight

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Improvement of glycaemic control with rebound following orlistat initiation and cessation associated with minimal weight change. / González, S.; Kilpatrick, E. S.; Atkin, Stephen.

In: Diabetic Medicine, Vol. 22, No. 3, 03.2005, p. 344-345.

Research output: Contribution to journalArticle

@article{55eabcad75af4328a29a9ed35eeab341,
title = "Improvement of glycaemic control with rebound following orlistat initiation and cessation associated with minimal weight change",
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?",
keywords = "Diabetes, Glycaemic control, HbA, Orlistat, Weight",
author = "S. Gonz{\'a}lez and Kilpatrick, {E. S.} and Stephen Atkin",
year = "2005",
month = "3",
doi = "10.1111/j.1464-5491.2005.01431.x",
language = "English",
volume = "22",
pages = "344--345",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Improvement of glycaemic control with rebound following orlistat initiation and cessation associated with minimal weight change

AU - González, S.

AU - Kilpatrick, E. S.

AU - Atkin, Stephen

PY - 2005/3

Y1 - 2005/3

N2 - 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?

AB - 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?

KW - Diabetes

KW - Glycaemic control

KW - HbA

KW - Orlistat

KW - Weight

UR - http://www.scopus.com/inward/record.url?scp=14644434407&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=14644434407&partnerID=8YFLogxK

U2 - 10.1111/j.1464-5491.2005.01431.x

DO - 10.1111/j.1464-5491.2005.01431.x

M3 - Article

VL - 22

SP - 344

EP - 345

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 3

ER -