Diabetes Q&A

Diabetes Risk Reduced With Appetite-Suppressant

Lorcaserin, a selective serotonin 2C receptor agonist and appetite-suppressant drug, is associated with a decreased risk of diabetes and increased rates of remission of high blood sugar, according to new research.

 

Because of the relationship between bodyweight and the risk of diabetes, researchers sought to examine the long-term effects of lorcaserin, which has been shown to facilitate weight loss in overweight patients, on diabetes prevention.


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They conducted a randomized, double-blind, placebo-controlled trial involving 12,000 participants randomly assigned to lorcaserin (10 mg twice daily) (n = 6000) or placebo (n = 6000), 6816 of whom had diabetes, 3991 had prediabetes, and 1193 did had normoglycemia. All participants were overweight (BMI ≥27 kg/m2) who either had or were at high risk for atherosclerotic vascular disease.

 

The primary endpoint was time to incident diabetes in patients with prediabetes at baseline, and secondary outcomes included incident diabetes in patients without diabetes, achievement of normoglycemia in patients with prediabetes, and change in glycemic hemoglobin (HbA1c) in patients with diabetes.

 

At 1 year, the net weight loss in patients treated with lorcaserin beyond that of patients treated with placebo was 2.6 kg for those with diabetes, 2.8 kg for those with prediabetes, and 3.3 kg for those with normoglycemia. Treatment with lorcaserin reduced the risk of diabetes by 19% in patients with prediabetes and 23% in those without diabetes and was associated with a non-significant increase in the rate of achievement of normoglycemia in patients with prediabetes. A reduction of 0.33% HbA1c was observed in patients with diabetes treated with lorcaserin compared with placebo at 1 year.

 

“Lorcaserin decreases risk for incident diabetes, induces remission of hyperglycemia, and reduces the risk of microvascular complications in obese and overweight patients, supporting the role of lorcaserin as an adjunct to lifestyle modification for chronic management of weight and metabolic health.”

 

—Michael Potts

 

Reference:

Bohula EA, Scirica BM, Inzucchi SE, et al. Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): a randomised, placebo-controlled trial [published online October 4, 2018]. Lancet. DOI:https://doi.org/10.1016/S0140-6736(18)32328-6.