Weight Management with Orlistat in Type 2 Diabetes - An Electronic Healthcare Records Study.

Ghosal, Shraboni; Heron, Neil; Mason, Kayleigh; Bailey, James; Jordan, Kelvin

Abstract

Orlistat is recommended as an adjunct to diet and exercise for weight loss in type 2 diabetes mellitus (T2DM). The aims were to explore (i) associations between patient characteristics and orlistat prescribing and to determine (ii) associations of orlistat with weight loss in T2DM/prediabetes. This cohort study used anonymised records of T2DM/prediabetes (2016-2017) patients ≥18 years, from the UK Clinical Practice Research Datalink (CPRD) database. Multivariable logistic regression models determined associations with starting orlistat and stopping it early (<12 weeks of prescriptions) and orlistat's associations with weight loss in those not prescribed 2nd line anti-diabetic medications. Out of 100,552 patients with incident T2DM/prediabetes, 655 (0.8%) T2DM and 128 (0.7%) prediabetes patients were prescribed orlistat. Younger people, females, those in more deprived regions, current smokers, co-prescribed metformin and recorded with hypertension were significantly more likely to be prescribed orlistat while higher baseline HbA1c levels were associated with early stopping. Those who continued orlistat for >12 weeks were more likely to lose ≥5% weight (adjusted OR: 1.69; 95% CI: 1.07, 2.67) than those not on orlistat, but those who stopped orlistat early were less likely (adjusted OR: 0.56; 95% CI: 0.29, 1.09). Orlistat was significantly associated with weight loss in T2DM/prediabetes when taken for at least 12 weeks. However, orlistat is infrequently prescribed and often taken for <12 weeks. Orlistat may be a useful adjunct to lifestyle modifications in T2DM/prediabetes however barriers to continuing orlistat means it may not be effective for everyone in managing weight loss. [Abstract copyright: Copyright © 2024, The Authors.]

Citation

Ghosal, S., Heron, N., Mason, K., Bailey, J., & Jordan, K. (in press). Weight Management with Orlistat in Type 2 Diabetes - An Electronic Healthcare Records Study. British Journal of General Practice (BJGP), BJGP.2023.0684. https://doi.org/10.3399/BJGP.2023.0684

• Journal Article Type: Article
• Acceptance Date: Apr 9, 2024
• Online Publication Date: Apr 15, 2024
• Deposit Date: May 8, 2024
• Publicly Available Date: May 8, 2024
• Journal: The British journal of general practice : the journal of the Royal College of General Practitioners
• Print ISSN: 0960-1643
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Pages: BJGP.2023.0684
• DOI: https://doi.org/10.3399/BJGP.2023.0684
• Public URL: https://keele-repository.worktribe.com/output/824103